The State of Ohio Flexible Spending Accounts (or FSAs) are voluntary accounts established under IRS Code Sections 125 and 129, which allow program participants to pay for eligible expenses on a pre-tax basis. Participants save on federal, state, some local taxes, and Medicare taxes. The State of Ohio offers two types of FSAs: a healthcare spending account for eligible health care expenses; and a dependent care spending account for eligible dependent care expenses. Program Enrollment does not roll over into subsequent plan years so participants must re-enroll to participate in each new plan year.

Click the links below to access the information you need quickly.

Healthcare Spending Account
Dependent Care Spending Account
Enrollment Eligibility
IRS Forfeiture Rule
FSA Enrollment Form
Submitting Claims
Fax Tips
Claim Rejection Reasons
FSA Debit Card
Direct Deposit
Card and IIAS Merchants
Appeals Process
FSA Online Presentation
Letter to 2012 Participants
FSA Resources

Health Care Spending Account

The health care spending account (HCSA) is a tax favored account that provides the opportunity for eligible employees to defer on a pre-tax basis up to a maximum of $3,000 into an account to pay for eligible expenses not paid by their health, vision or dental insurance plans. There is no administrative fee for participants. A payment card, similar to a debit card, is issued to all participating employees; the WageWorks Health Care Card facilities payment of eligible healthcare expenses. Information regarding eligible expenses may be found in the FSA Reference Guide. For more detailed information about the HCSA or the payment card please visit the web site for the State of Ohio’s program vendor, WageWorks, Inc.

Dependent Care Spending Account

The dependent care spending account (DCSA) is a tax favored account that provides the opportunity for eligible employees to defer on a pre-tax basis up to a maximum of $5,000 (dependent on tax status) into an account to pay for eligible child care, dependent care, and eldercare expenses. For more detailed information about the DCSA please visit the web site for the State of Ohio’s program vendor, WageWorks, Inc. 

Enrollment Eligibility

Health Care Spending Account (HCSA)

Employee must be a permanent part time or permanent full time employee with sufficient pay to cover the election amount.

  1. May enroll within 30 days of the hire date, if no probationary period.  
  2. May enroll within 30 days of completing probation, if there is a probationary period. 
  3. It is not necessary that the employee be enrolled in the State of Ohio’s Health Benefits in order to participate in the HCSA.
  4. If both a husband and wife are State employees, both may participate in the HCSA as separate individuals.

Dependent Care Spending Account (DCSA)

Employee may enroll within 30 days of the hire date if:

  1. Employee is a permanent part time or permanent full time employee with sufficient pay to cover the election amount.
  2. Employee has a qualifying dependent(s).

If an employee does not enroll within the timeframes noted above, other opportunities to enroll are as follows: 

  1. During the annual open enrollment period.
  2. Upon experiencing an IRS qualifying status change; According to the IRS regulations governing Section 125 Cafeteria Plans a change can be made to the employee’s pre-tax salary reduction election. However, the proposed change must be consistent with the type of change experienced. Contributions and benefit changes must an appropriate result of the Changes in Status. The timeframe for notification is within thirty (30) days of the qualifying event.

For more information on qualifying events, see the FSA Qualifying Events Chart.

IRS Forfeiture Rule

"Federal regulations require that any unspent balance at the end of the calendar year, or at the end of the month of your employment termination, will be forfeited. To avoid possible forfeiture at the end of the year, please use the worksheets below to calculate the appropriate FCSA and/or DCSA amounts."  


Health Care Spending Account (HCSA) Worksheet

Dependent Care Spending Account (DCSA) Worksheet

Health Care Spending Account (HCSA) Worksheet

Dependent Care Spending Account (DCSA) Worksheet

Flexible Spending Account (FSA) Enrollment Form

2012 Enrollment Form
Flexible Spending Account Enrollment Form 2011

Claims Fax Tips

In order to prevent the need to re-submit / re-fax a FSA claim 

  1. Assure that any documents faxed are properly positioned face up/down based on your faxing equipment's requirements. This will assure that blank pages are not received by (FB-WW).
  2. Assure that the ink on the documents faxed is dark enough for fax to be received clearly.
  3. Assure that the item(s) on your faxed document are not highlighted. Highlights will make items on your faxed document illegible, once received.
  4. Receipts on colored paper or glossy (thermal paper) may not be legible, once received.

Claim Rejection Reasons

Top reasons that Claims are rejected or additional information is requested by (FB-WW) are: 

  1. Claim is submitted without a description or code for the type of service
  2. Claim is submitted without the date of service
  3. Claim is submitted without supportive documentation for expenses
  4. Claim form is submitted unsigned

How Does the FSA Payment Card Work?

Your myFBMC Card® works just like a credit card. There is no annual fee. All that is needed is to swipe your card at a participating provider to purchase eligible items from your health care spending account. The card does not use a PIN so there is no need to remember yet another four-digit code. It’s versatile. The payment card enables health care spending account participants to access their account benefits more quickly to pay eligible expenses. The card can be used at retail pharmacies, such as Target, Wal-Mart, Sam’s Club and Walgreens. To view the entire Store List IIAS Store List for a constantly updated list of retailers and providers accepting the card.

Keep your receipts! You may need to provide receipt documentation on occasion. For example, documentation may be required for purchases that are made for office (doctor, dentist, vision provider) visit fees, copayments, co insurance, deductibles and at some retailers i.e. non IIAS certified pharmacies. See the Special Drug Store Notice below.

The IRS requires payment card suspension, when substantiating documentation is not provided for expenses requiring such. A grace period of 60 days is provided to allow payment card users reasonable time to submit the required documentation. When your monthly FB-WW statement and/or an online account message requests substantiating documentation, provide that your documentation is received by FB-WW within the 60 day grace period.

If you do not submit documentation to FB-WW within 60 days, your myFBMC Card® may be suspended, as required by IRS guidelines. Submit a completed FSA claim form to avoid deactivation of your card.

You may contact FB-WW at 1.800.342.8017, should you have questions or need assistance in determining whether your provider is IIAS-Certified. Customer Care Center representatives are available Monday through Friday, 7 am to 10pm EST.

A payment card is not yet available with the dependent care spending account.

Direct Deposit

You may want to enroll in direct deposit to expedite the time of your reimbursement.
FSA reimbursement funds are automatically deposited into your checking or savings account within 48 hours of your claim approval.  There is no fee for this service.  You do not have to wait for postal service delivery of your reimbursement. However, you will receive notification via mail that the claim has been processed.

To apply, complete the Direct Deposit Form or call Customer Care Center at 1.800.342.8017 for assistance. Please note that processing your direct deposit enrollment may take four to six weeks.

Card and IIAS Merchants

Over-the-Counter and prescription purchases with the card are only accepted at IIAS certified merchants. For all other qualified expenses, such as medical and dental co-payments, the myFBMC Card® may be used normally. To find out if a pharmacy or drugstore near you accepts the card, please refer to the IIAS Certified Store List at

Employees may contact FB-WW at 1.800.342.8017 for information regarding pharmacy IIAS certification.

Appeal Process

If you have a request for a mid-plan year election change, FSA reimbursement claim or other similar request denied, in full or in part, you have the right to appeal the decision by sending a written request within 60 days of the denial for review to:

Fringe Benefits Management Company, a Division of WageWorks
Attn: Appeals Process
P. O. Box 1878
Tallahassee, FL 32302-1878.

Your appeal must include:

  • the name of your employer
  • the date of the services for which your request was denied
  • a copy of the denied request
  • the denial letter you received
  • why you think your request should not have been denied and
  • any additional documents, information or comments you think may have a bearing on your appeal.

Your appeal and supporting documentation will be reviewed upon receipt. You will be notified of the results of this review within 30 business days from receipt of your appeal. In unusual cases, such as when appeals require additional documentation, the review may take longer than 30 business days. If your appeal is approved, additional processing time is required to modify your benefit elections.

Note: Appeals are approved only if the extenuating circumstances and supporting documentation are within your employer's, insurance provider's and the IRS’ regulations governing the plan.

FSA Resources

2012 Reference Guide


For questions about flexible spending accounts, contact the Customer Care Center at 1.800.342.8017. Customer Care Center Representatives are available 7 a.m. – 10 p.m. EST Monday through Friday.


General Contact

Department of Administrative Services
30 East Broad Street, 27th Floor
Columbus, Ohio 43215
614-466-8857 Local
800-409-1205 Toll Free

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