What is a Flexible Spending Account (FSA)?

It is a pre-tax benefit account use to pay for eligible expenses. The Medical Expense Reimbursement Program (MERP) can be used for qualifying medical, dental, and vision care expenses. The Dependent Care Assistance Plan (DCAP) can be used to pay for childcare expenses such as preschool, before or after school programs, and elder daycare. The Transportation Reimbursement  Plan (TRP) can used to pay for eligible commuting expenses to/from work (two types of TRP's are available; one for parking and one for transit). Employee contributions are made with pre-tax payroll deductions. 
Be sure to review all the details of these plans prior to making your decision to enroll, as these plans are strictly regulated by the IRS and operate under Sections 125 and 132 of the Internal Revenue Code. 

How do FSAs work?

  • FAQ's for Flexible Spending Accounts
  • Begin by estimating your eligible, out-of-pocket health care and/or dependent care expenses for the upcoming year.
  • Use your estimate to enroll in a MERP and/or DCAP account.
  • The money you elect for your FSA will be automatically deducted from your paycheck on a pre-tax basis. 

When can I sign up?

  • New hires can sign up within 31 days of employment.
  • Every Open Enrollment period (Oct. - Nov.), you can sign up for MERP/DCAP for the following plan year. 
  • You may also be able to change or enroll during the plan year due to certain qualifying events (new baby, marriage, some job changes).
For more information, email employee.benefits@multco.us or call 503-988-3477.

PacificSource Administrators

Customer Service:  Toll Free 800-422-7038  --  https://psa.pacificsource.com/Flex/

FSA Forms

2017 FSA MERP/DCAP Enrollment Form (208.19 KB)

TRP Enrollment/Change Form (188 KB)

2017 MERP/DCAP Change Form (251.71 KB)

FSA MERP/DCAP Reimbursement Form (105.96 KB)

Parking TRP Reimbursement Request Form (106.36 KB)

FSA Direct Deposit Setup (99.36 KB)

FSA Letter of Medical Necessity (64.22 KB)

Dependent Care Recurring Expense Form (142.65 KB)

FSA Documents and Information 

Guide to MERP (319.16 KB)

Guide to DCAP (181.75 KB)

FSA MERP OB Guidelines (20.69 KB)

FSA MERP Ortho Guidelines (26.99 KB)

FSA MyFlex Online Claims Instructions (27.72 KB)

FSA MERP Benny Card Flier (595.1 KB)

TRP Eligible Commuter Expenses List (105.58 KB)