you do not make a payment on time, you may submit claims only for expenses incurred through your last active month of paid participation. You also cannot receive reimbursement from your Medical FSA if the date of service for the expense is during an unpaid work period when eligibility is lost. For example, if you lose eligibility beginning July 1, you can only receive reimbursements for the rest of the plan year if: • You continue making contributions directly to Navia Benefit Solutions during the months of July through December, and • The dates of service for the expenses occur during the months you continue to contribute. Finally, if you maintain your Medical FSA contribution during continuation coverage through December 31, you can submit claims to Navia Benefit Solutions through the following March 31, for your Medical FSA balance. What happens if my employment ends? A Medical FSA is an employee benefit. As a result, except as noted in the “When Can I Make Changes“ section, when your employment ends, you retire, or you go on unpaid leave that is not approved FMLA or military leave, you can no longer contribute to your Medical FSA. This means that your participation ends on the last day of the calendar month in which you were employed. You will only be able to claim expenses incurred while employed, up to your available balance, unless you are eligible to continue coverage (WAC 182-12-133). You may continue to submit claims for reimbursement to Navia Benefit Solutions until March 31, 2025. Except as stated in the “Continuation coverage through COBRA” section, Navia Benefit Solutions will not reimburse any expenses incurred while you were not actively enrolled in a Medical FSA. If you end employment during the plan year or retire, contact your payroll or benefits office to find out if you can request one of the options below. Not all agencies can accommodate the options. • Stop deductions: Your deduction and participation will stop at the end of the month in which you are benefit-eligible. You may be reimbursed only for services incurred on or before the termination date. You can submit claims for reimbursement to Navia Benefit Solutions until March 31, 2025. • Accelerate deductions: You can authorize your employer to take future deductions from your final paycheck only. This final deduction will be pre-tax and you can participate in the plan to the extent contributions are made. • Continue with COBRA: Under certain circumstances, you may be eligible to continue participation through Navia Benefit Solutions on an after-tax basis through COBRA. (See “Continuation coverage through COBRA” above.) How do I appeal a denied claim? You will receive written notice of any denied claims within seven calendar days of when Navia Benefit Solutions receives the claim. The notice will include the reasons for the denial, a description of any additional information needed to process the claim, and an explanation of the claims review procedure. You may resubmit your claim to Navia Benefit Solutions with additional information no later than March 31, 2025. If you wish to file an appeal, Navia Benefit Solutions must receive your appeal no later than 30 calendar days from the date the denial was issued. Your appeal must include: • A statement outlining why you think your request should not have been denied • Your employer’s name • The dates of the services denied • A copy of your original claim • A copy of the denial letter you received 13
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