Table of Contents

CSU Health Care Reimbursement Account (HCRA)

New and continuing participants must complete the DCRA/HCRA Enrollment Authorization Form (PDF, 257KB) .

This plan allows you to pay for eligible out-of-pocket health expenses on a pre-tax basis. Contributions to this plan are deducted from your pay prior to federal, state, and social security (FICA) taxes being withheld. A $1.00 after-tax administrative fee will be deducted from your pay each month you participate. You must estimate your eligible expenses very carefully. Any funds left in your HCRA after your expenses have been paid for the year will be forfeited. These funds are held in your personal HCRA account until you incur eligible expenses and file a claim for reimbursement.

Reimbursement claim forms are available on the ASI website at: http://www.asiflex.com/. In order to enroll during this enrollment period, you will need to complete the DCRA/HCRA Enrollment Form (PDF, 257KB) and return it to Human Resources, Lindero 1804, by Friday, October 6, 2017.

Eligible Expenses

Medical, dental, and vision expenses eligible to be reimbursed by the HCRA Plan include uninsured and medically necessary expenses incurred by you and your dependents. Expenses must be incurred for the diagnosis, cure, treatment, or prevention of disease; for treatment affecting any part or function of the body; or to alleviate or prevent a physical defect or illness. Expenses incurred solely for cosmetic reasons or expenses that are merely beneficial to a person’s general health are not eligible for reimbursement.

For detailed information on HCRA, please refer to the HCRA brochure (PDF, 202KB) or refer to Internal Revenue Service (IRS) Publication 502 on the IRS website at http://www.irs.ustreas.gov/ for additional information.

Flexible Spending Plan (FSA) debit card for HCRA Enrollees

The optional ASIFlex Visa Card, allows HCRA enrollees to pay for out-of-pocket medical expenses (i.e., health, dental, vision, etc.) as payment at Health Care Providers and at certain retail locations.

You may obtain the ASIFlex Visa Card by completing the “ASI Flex Debit Card App” and sending the form to ASIFlex. ASIFlex Visa Card request forms received during open enrollment or in December 2017 will be issued in mid- January. Cards requested after this timeframe will typically be issued within 10-15 days of the receipt of the form. For more information about the ASIFlex Visa Card, including FAQs, please visit the ASIFlex website. To enroll in the the ASIFlex Visa Card, complete the ASI Debit Card Application (PDF, 70.3KB) and follow the form instructions for submitting it to ASIFlex.

CSU Dependent Care Reimbursement Account (DCRA)

New and continuing participants must complete the DCRA/HCRA Enrollment Authorization Form (PDF, 257KB) .

This plan provides for payment of certain dependent care expenses from your pre-tax income, via a special tax-free account set up for this purpose. Each month, the amount you select is deducted from your salary before federal, state, and social security (FICA) taxes are withheld. These funds are held in your personal Dependent Care Reimbursement Account (DCRA) until you incur eligible expenses and file a claim for reimbursement. Reimbursement Claim forms are available at www.asiflex.com.

For detailed information on DCRA, please refer to the DCRA brochure (PDF, 154KB) or refer to Internal Revenue Service (IRS) Publication 503 on the IRS website at http://www.irs.ustreas.gov/ for additional information. A $1.00 after-tax administrative fee will be deducted from your pay each month you participate. In order to enroll during this enrollment period, you will need to complete the DCRA/HCRA Enrollment Form (PDF, 257KB) and return it to Human Resources, Lindero 1804, by Friday, October 6, 2017.

Eligible Dependents

Eligible dependents for whom DCRA reimbursements can be claimed are: (a) a child under the age of 13, for whom you or your spouse can claim dependent status on your income tax return, (b) a financially dependent member of your household who is physically or mentally disabled and who regularly spends at least 8 hours each day in your home, and/or (c) a spouse who is physically or mentally unable to care for him/herself.

HCRA and DCRA Eligibility

Represented and non-represented employees (regardless of time base or duration of appointment) are eligible to participate in the HCRA/DCRA Plans with the exception of student assistants, graduate assistants, summer session faculty, rehired annuitants including FERP participants, and intermittent/hourly staff.

The minimum monthly contribution for HCRA is $20 per month ($240 annually), up to a maximum contribution amount of $216.66 per month ($2,600 annually).

The minimum monthly contribution for DCRA is $20 per month ($240 annually), up to a maximum contribution amount of $416.66 per month ($5,000 annually).

Go to the How to Make Changes page to learn how to enroll/re-enroll in DCRA/HCRA.