Flexible Spending Accounts (FSA)

Flexible Spending Accounts

Employees of the City and County of San Francisco and the Superior Court of San Francisco can use a Flexible Spending Account (FSA) to save money on certain healthcare and dependent care expenses. There are two types of FSA accounts offered by the San Francisco Health Service System (SFHSS). The Health Care FSA (HCFSA) covers common medical expenses for members and their dependents, such as, co-payments, prescription drugs and certain over-the-counter products. The Dependent Care FSA (DCFSA), which covers childcare and care for elderly family members who are incapable of self-care. With FSAs, you can save up to 40% by using pre-tax dollars. 

The FSA is managed by P&A Group, and they offer online tools and smartphone apps to help you easily submit expenses for reimbursement. You can learn more about how the FSA works by reading the brochure. You can sign up for an FSA during open enrollment or when you're a new employee. The money you choose to put into your FSA is taken out of your paycheck before taxes and put into your FSA account with the P&A Group. Then, you can submit receipts for qualifying expenses to get your money back.

You can choose to make contributions to a Healthcare FSA, a Dependent Care Assistance FSA, or both.
 

Healthcare Flexible Spending Accounts

A Healthcare FSA allows you to pay with pre-tax dollars for qualifying health care expenses for you and your eligible family members. The full annual amount is available to you after the first contribution has been deducted. Deductions will be taken bi-weekly from your paycheck. P&A will issue a debit card to make spending and claims processing easier. You can also submit a claim for reimbursement via a smartphone app, online, fax or mail for the following types of expenses:

• Medical,
• Pharmacy,
• Dental and Vision co-pays,
• Chiropractic and Acupuncture care, 
• Menstrual products
• Certain over-the-counter medications
• Sunscreen
• and more

Click here for a list of eligible items for FSA reimbursement. These items can be purchased using you FSA debit card at most major retailers. For an expanded list of eligible products please visit FSA Store. 

Healthcare FSAs: 

• You may set aside up to $3,300 on a pre-tax basis for your 2026 Healthcare FSA account.
• The new carryover amount for 2026 funds will be a minimum of $10 and a maximum of $660 into the 2027 plan year.

At the end of the plan calendar year, unclaimed funds between the minimum an maximum allowed amounts can be carried over for use in the next plan year for one year. Any unclaimed funds of less than the minimum and more than the maximum will be forfeited, per IRS rules. There are no exceptions.

P&A Group has a list of deductions that qualify for FSA reimbursement here. Healthcare FSA Expenses must be incurred between January 1st and December 31st of the plan year. All claims must must be submitted by March 31st before 11:59pm of the following calendar year. 

Dependent Care Assistance Flexible Spending Accounts 

A Dependent Care Assistance FSA allows you to pay for certified day care, pre-school and elder care needed by eligible children under age 13 or aging parents. The allowed dependent care services must be incurred to enable you to work. Note: If you have a stay-at-home parent in your household, you are not eligible for a Dependent Care Assistance FSA.

Dependent Care FSA is a "pay as you go" account where you must have enough funds in your account before you may submit a claim for reimbursement. Unlike Healthcare FSA, there is no carry-over option with the Dependent Care FSA. Expenses and services must be incurred in the same plan year or the funds will be forfeited. For a list of eligible dependent care expenses, click here. 

Beginning January 1, 2026, the maximum contribution you can set aside for your Dependent Care Flexible Spending Account (FSA) will be based on your annual salary to accommodate the higher allowable maximum and comply with the IRS Highly Compensated Employee (HCEs) requirements.

After You Enroll
After you are enrolled, there are four ways to submit an FSA claim to P&A Group:

• Benefits debit card. Your card will arrive in a plain white envelope at your mailing address. The card expiration date is printed on the front, and a replacement card will be mailed automatically before it expires. Additional cards for dependents can be ordered through your P&A account or by contacting P&A Group.This allows you to swipe a card at the point-of-service. The qualifying expense will be deducted from your Flexible Spending Account balance. 
   
• Submit a claim from your smartphone. Take a picture of the receipt or other supporting documentation. Go to the P&A website on your smartphone. Log into your P&A Account and select upload.
   
• Submit a claim from your desktop computer. Scanning a receipt or other documentation. Log into your P&A Group account and select upload.
   
• Submit a paper claim. Download and complete the Claim Form below under Plan Resources. Send to P&A Group, along with required documentation for your eligible expense.
   
• Toll-free fax: (877) 855-7105
   
• Mailing address: P&A Group, 6400 Main Street, Suite 210, Williamsville, NY 14221

Consult with your tax advisor or the IRS about your specific situation and your potential tax savings with an FSA. View IRS Publication 502 for information about the Healthcare FSA, and IRS Publication 503 for details about the Dependent Care Assistance FSA.

In some cases, due to certain qualifying events, a member may be allowed to initiate or modify FSA contributions during the plan year. A maximum of two benefit election changes due to qualifying events may be made per year. Contact SFHSS Member Services at (628) 652-4700 if you have questions about an FSA and a qualifying event.

FSA Administrator: P&A Group

Questions? 
P&A Group administers FSA's on behalf of SFHSS, including processing reimbursement forms. P&A Group's mailing address is: P&A Group, 6400 Main Street, Suite 210. Williamsville, NY 14221 and their toll-free fax number is (877) 855-7105. Contact P&A Group by visiting padmin.com or calling (800) 688-2611.