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Flexible Spending Account (FSA) Forms and Documents

Flex Administrators has moved

Flex Administrators, Inc.
3980 Chicago Drive
Suite 230
Grandville, MI 49418
Office: (616) 456-7908 Fax: (616) 454-6090

Important Changes to FSA Health and Dependent Care

In response to the Covid-19 pandemic Grand Rapids Community College has chosen to adopt temporary changes for Flexible Spending Accounts. The 2021 Consolidated Appropriations Act, signed into law on December 27, 2020, provided employers the option to significantly increase the flexibility of employees’ health and dependent care flexible spending accounts (FSAs). These changes were prompted by the COVID-19 pandemic, as many health care providers have limited access to routine treatments and many child care services have been suspended, potentially leaving FSA funds unused. The American Rescue Plan Act (ARPA), signed into law on March 11, raises pre-tax contribution limits for dependent care flexible spending accounts (DC-FSAs) for calendar year 2021.

Increase in FSA Dependent Care Contribution Limit

The American Rescue Plan Act (ARPA), signed into law on March 11, raises the pre-tax contribution limits for Dependent Care Flexible Spending Accounts (DC-FSAs) for the 2021 calendar year. The new Dependent Care-FSA annual limits for pre-tax contributions increases to $10,500 (up from $5,000) for single taxpayers and married couples filing jointly, and to $5,250(up from $2,500) for married individuals filing separately. New Stimulus Law Extends Time to Spend 2020 Health FSA and Dependent Care Balances.

Dependent Care Grace Period Extended to 12 months

Under the Consolidated Appropriation Act, 2021 (CAA), signed into law at the end of 2020, the grace period for unused FSA Dependent Care funds has been extended from 2 ½ months to 12 months. 100% of unused FSA funds from 2020 are available for use until the end of the 2021 calendar year. The grace period extension also applies to the 2021 calendar year. Unused FSA funds from 2021 will be available to be used until the end of the 2022 calendar year.

FSA Health Care Carryover

100% of unused FSA Health Care Funds from the 2020 plan year will carry over for use during the 2021 plan year. Likewise, the Flexible Spending plan, participants with unused funds remaining at the end of the 2021 plan year may carry those funds over for use in the 2022 plan year. Normally, the carry-over amount is limited to $550 for health FSAs

Post-Termination Reimbursement:

Employees who stopped participating in an FSA in 2020 or 2021 can continue to receive
reimbursements from unused benefits or contributions through the end of the plan year when
participation has ended.

Mid -Year FSA Elections

Ordinarily, your FSA election is irrevocable during the plan year, unless you experience an IRS approved status change event such as marriage, divorce, birth, death, or change in employment status. The act temporarily permits GRCC to allow participants to make mid-year election changes to Flexible Spending Accounts (i.e., to elect FSA accounts, increase or decrease FSA contributions, or cancel FSA contributions) for plan year ending in 2021 for any reason. Keep in mind that these changes can only be made prospectively. No retroactive changes are allowed. If you would like to request a Flexible Spending Account contribution change, please complete the FSA Change in Status Form  below and submit 10 days prior to the next payroll cycle. You can email your completed FSA Change in Status Form to:

Personal Protective Equipment Covered under FSA

The IRS has issued guidance in Announcement 2021-7 that personal protective equipment (PPE) that prevents the spread of COVID-19 is treated as an expense incurred for medical care under 213(d). This means that PPE can now be reimbursed through Flexible Spending or Health Savings Account. PPE can be for the participant as well as the participant’s spouse and dependents. This guidance is effective retroactively back to 1/1/20 so any PPE expenses incurred on/after 1/1/20 are eligible.


  • Masks
  • Hand sanitizer
  • Sanitizing wipes
  • Disposable gloves
  • Any other equipment for the primary purpose of preventing the spread of COVID

PPE coverage change applies to protective equipment only. Vitamins and supplements taken as a preventive regimen will require a letter of medical necessity to be eligible for reimbursement.

Changes from 2020; The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) Cares Act:

Over-the-counter drugs and medicines can be paid for or reimbursed through a Flexible Spending Account without a doctor’s prescription. Menstrual care products are now considered a qualified medical expense and are eligible for payment or reimbursement through an FSA, HRA or HSA.

If you have any questions regarding the Flex Spending Account changes, please feel free call or email Debra Davis at (616) 234-4175/ or Maria Belmares Herrera at (616) 234-4052/

Flexible Spending Account

A Flexible Spending Account is a special account through which pre-tax money is deducted from your paycheck to use to pay for eligible out-of-pocket health care costs such as office visit co-pays, deductibles or prescription co-pays.

FSA Documents


FSA Forms

If you do not find the information you are looking for please contact the HR Benefit Department.