the debit card you received previously. If you did not receive this benefit previously, Navia will send you a debit card loaded with $250. Use the debit card for eligible health care expenses by December 31, 2024. If you enroll in an FSA for 2025, or have at least $120 left in your account on December 31, 2024, the funds will carry over into the next year. If you have less than $120 left in your account, and you do not enroll in an FSA for the next plan year, the funds will be forfeited after December 31, 2024. See the “Carryover and use it or lose it” section for details. • If you enroll in a Medical FSA for 2024, the $250 contribution will be added to your account with Navia Benefit Solutions in by February 1, 2024. You will not receive this benefit if: • You enroll in a consumer-directed health plan (CDHP) with a health savings account (HSA). This limitation is an Internal Revenue Service rule. However, due to the carryover feature, if you enroll in a CDHP for the following year and still have at least $120 of the $250 benefit left in your account from the previous year, that amount will be converted to a Limited Purpose FSA. • You waive PEBB medical coverage, unless you waive to enroll as a dependent on someone else’s PEBB medical plan (that is not a CDHP). If you cannot receive the $250 for these reasons, the collective bargaining agreement does not allow the $250 to be distributed or used in any other way. You will forfeit this benefit. Whose expenses qualify? The Medical FSA covers health care expenses that occur during the plan year for you, your spouse, or your qualified dependents, even if they are not enrolled in your PEBB medical or dental plan. You may also claim certain expenses for a child for whom you don’t get the tax exemption due to a divorce decree, so long as one parent claims the child as a dependent. The exemption may switch from year to year between parents. If one parent receives the tax exemption, the medical or dental expenses you pay on behalf of the child may qualify for the Medical FSA reimbursement. What health care expenses are eligible? Below is a list of common expenses that may be eligible for reimbursement. Not all eligible items are on this list. For a full list, visit pebb.naviabenefits.com/benefits/expenses or call Navia Benefit Solutions at 1-800-669-3539. Acupuncture Cold/cough medication Home medical equipment Prescription glasses Allergy & sinus medication Contacts & solutions Individual counseling Reading glasses Antacids Contraceptives Insect bite treatment Respiratory treatments Antibiotic ointment Copays Lab work Saline nasal spray Anti-diarrheal CPAP machine Lactation consultant Sleep aids & sedatives Antifungal foot cream Crutches Lactose intolerance pills Sleep deprivation Anti-gas medication Deductibles Laser eye surgery treatment Anti-itch cream/gel Dental services Laxative Smoking cessation Antiseptic Diabetic supplies Lice treatment products programs and products Asthma treatment Diaper rash ointment Menstrual care products Speech therapy Bandages/gauze Digestive aids Motion sickness relief Sterilization procedures Birthing classes or Drug addiction treatment Naturopathic visits Stool softener* Lamaze Ergonomic items Orthodontia Sunscreen SPF 15 or Blood pressure monitor Feminine anti-fungal/anti- Oxygen and equipment more Braces (knee, ankle, wrist) itch Pain relievers Thermometer Breast pump Fertility monitor Parasitic treatment Throat lozenges Braille books Fertility treatment Physical exams Vaccinations Burn cream Flu shots Physical therapy Vision care Chiropractic services Hearing aids & supplies Pregnancy test Walker Coinsurance Hemorrhoid medication Prenatal vitamins Wart treatment Cold sore treatment Prescription drugs Wheelchair & repair 5