Medical Expense Reimbursement Program (MERP)

Detailed information about MERP

On this page

  1. MERP FAQs and Important Resources
  2. MERP Forms
  3. MERP Documents and Information

MERP FAQs and Important Resources

What is MERP?

MERP is a Flexible Spending Account (FSA). It is a pre-tax account to use to pay for eligible medical, dental, and vision care expenses that aren't covered by your insurance plan.

How does MERP work?

  • You will want to begin by estimating your eligible, out-of-pocket health care expenses for the upcoming year.
  • Use your estimate to enroll in MERP when you are first hired, annually during open enrollment, or if you have a qualifying MERP change event during the year.
    • Plans elected during Open Enrollment are effective January 1st through December 31st of the upcoming year.
    • For new hires and eligible mid-year changes, plans begin on the first of the month on or following the hire date/change event date AND the employee's submission of the change request in Workday. The plan ends December 31st following the effective date.
      • For example, a May 5th new hire who submits their enrollment elections on or before June 1st, will have a plan start date of June 1st. So, they will want to elect an amount that is appropriate for June 1st through December 31st of the current year.
    • Expenses must be incurred in the period that the plans are effective to be eligible for reimbursement.
  • The money you elect will be deducted from your paycheck on a pre-tax basis. This means that your dollars go farther because the funds you set aside for this account are not taxed, they go straight to your MERP account for eligible expenses.

What are the most important things I need to know about MERP?

  • MERP funds can be used for eligible out-of-pocket expenses for yourself and/or your dependents (spouse and eligible children).
    • Domestic Partners and their children that are not also your biological or adopted children, and other dependents you may be supporting, are not considered eligible dependents under federal law; therefore you cannot claim their expenses (unless they are a "qualifying relative" per the IRS, consult a tax professional for more information about qualifying relatives).
  • You have access to your total annual amount for MERP on January 1st of the plan year for Open Enrollment, or the plan effective date for new hires and eligible mid-year changes.
    • This is a great benefit if you have a deductible or consistent medical expenses for which you pay out-of-pocket. You know you will have the funds ready for whatever comes up.
  • New participants will receive a MERP debit card (formerly known as Benny card) in the mail, which can be used for eligible expenses at pharmacies, drug stores, medical providers and some online retailers that sell eligible supplies. Contact PacificSource directly if you do not receive your card within two weeks of the first MERP deduction from your paycheck, or if you need a replacement card.
    • Make sure that your mailing address is correct in Workday to ensure your card and important plan notices get to you.
  • For 2024, the minimum annual amount is $240, and the maximum is $3,050. For 2025, the minimum annual amount is $240 and the maximum is $3,200. Up to $640 in unused funds may be carried over at the end of the year for 2024. Funds in excess of the $640 rollover limit are subject to the “use it or lose it” rule.
    • If your plan ends before the end of the year due to unpaid leave, loss of eligibility for the benefit (termination of work or transition to on-call/not benefit eligible), or due to an elective cancelation, remaining funds will not roll over into the new year.
  • Eligible expenses incurred through 12/31 of the plan year may be submitted for reimbursement to PacificSource through 3/31 of the following year.

What are some examples of MERP eligible expenses?

  • Copays
  • Prescription medications
  • Glasses, contact lenses, and contact lens solution
  • Asthma inhalers
  • Blood pressure monitors
  • Lasik
  • Sunscreen
  • Acupuncture
  • Chiropractic
  • Glucose monitors
  • Face masks (cloth and medical)
  • Many fertility procedures and medications
  • Over the counter medicines like: pain relievers like aspirin and ibuprofen, antihistamines, decongestants, cough syrup, throat lozenges, eye drops, etc.
  • First aid supplies like: bandages and antibiotic ointments
  • Menstrual care products
  • See more on the
    . Note: The IRS decides what items are eligible for medical reimbursement
    • Some items listed require a
      in order to be eligible.       These items are noted as such in the list; please check item notes carefully before making a purchase or contact PacificSource if you are unsure: 800-422-7038.

When can I sign up? When can I change my MERP plan?

  • Within 31 days of employment or eligibility
  • During every Open Enrollment period (Oct. - Nov.), you must enroll for the upcoming year to continue participating. Re-enrollment is not automatic!
  • You can also change, end, or enroll in MERP throughout the year if you have a qualifying MERP change event.
    • Qualifying MERP change events include (but are not limited to): having new baby, marriage, certain job changes, or changes to other coverage.
    • Plan change must be consistent with the change event. For example, a new child allows you to enroll or increase your MERP plan, but not reduce or cancel.
    • Changes must be requested within 60 days of the qualifying MERP change event.
    • Contact employee benefits with the details about what change you want to make, and the date and description of the event that is instigating the change and we can guide you further.

What if I leave County employment mid-way through the year?

  • MERP plans end at the end of the pay period in which you left county employment, and claims after the end of that pay period are not eligible for reimbursement.
  • You can continue participating through MERP COBRA.
  • If you leave County employment having not spent all the funds you have contributed, those funds are forfeited unless you participate in MERP COBRA.
  • If you leave County employment having spent more funds than you have contributed, those funds are not collected back from you.

What are the differences between MERP and HRA VEBA?

There are many similarities between MERP and HRA VEBA. HRA VEBA is only available to employees in specific bargaining units and those who qualify are automatically enrolled. Find out more on our HRA VEBA page.

How to I get MERP account access & customer support?

Access your MERP account through PacificSource (PSA). You are given a username and password upon enrollment. If you have questions about submitting expenses, expense eligibility, or need help creating or accessing your account, please contact PSA by email or call 800-422-7038.

What do I need to know about submitting claims, using my MERP debit card and substantiating claims?

  • DEFINITION: FSA substantiation is the process of providing proof that funds from a Flexible Spending Account (FSA) were used for eligible medical expenses. The IRS requires substantiation in exchange for allowing the funds to be used tax-free.
  • WHY?: Probably the #1 question regarding FSA accounts. It seems intuitive that expenses incurred at a medical provider or pharmacy should just go through, right? However, the retail systems, insurance companies, PacificSource (PSA), and medical providers don't all have connected systems, and documentation provided by retailers and medical providers can be incomplete or not match up with amounts or dates of service. PSA must substantiate debit card purchases and other claims you submit to ensure that they are IRS eligible expenses. You will receive notifications in the mail from PSA if you need to provide more information for claims substantiation. The substantiation process may require you to:
    • Get a letter of medical necessity from your medical provider confirming that certain kinds of expenses are medically necessary.
    • Provide PSA with detailed medical claim information such as an EOB (Explanation of Benefits) from your insurance company, or a "superbill" from your medical provider.
    • Repay funds or "offset" with qualifying expenses, expenses that were later determined to be ineligible that went through on your MERP debit card or out of pocket expenses that were previously reimbursed to you.
  • TIP: The IRS requires 5 pieces of information to fully adjudicate or clear a MERP debit card transaction:
    • Date of service - this may be different from the date of payment
      • Dates of service must be within the same plan year as the account contributions; your 2024 dates of service can only be reimbursed out of the 2024 plan accounts.
    • Patient name
    • Provider name
    • Type of service
    • Final patient responsibility after all insurances have processed and paid
  • TIP: Always open your mail from PSA! It may include your MERP debit card, or important notices requesting more information to back up your claims and MERP debit card charges.
    • If requests for documentation are not responded to promptly, your MERP debit card may be temporarily suspended.
    • If your MERP debit card is not working when it was previously, it's likely that you have some outstanding documentation requests to clear up with PSA.
  • TIP: Save all receipts from purchases made with your MERP debit card, or paid out-of-pocket with other funds. Even if the MERP debit card transaction is approved at the pharmacy, online retailer, or your medical provider's office, you will most likely still need to substantiate the claim with a receipt or other information.
  • TIP: Set up your PSA Consumer website and Mobile App access to quickly and easily keep track of your receipts and account needs. The Mobile App even has a barcode scanner to confirm eligibility of an over the counter item!
  • TIP: Sign up for, and get familiar with your insurance company's online portal so you can be ready to obtain EOBs to submit claims and substantiate MERP debit card charges.
    • EOBs are the most complete and reliable information for you to provide PSA with regarding your claims as they include all the needed information such as date of service, patient responsibility (what you paid), provider name & details, and treatment codes.
    • A retail/point of sale receipt and most medical provider statements do not include all the necessary information. We recommend submitting EOBs to PSA over other types of documentation. A "superbill" if your medical provider can provide one, is the next best thing. Account ledgers/statements from medical providers, and point of sale receipts are often rejected.
  • TIP: We recommend paying providers after your claim has been submitted to and paid by your insurance company. Estimated or pre-pay amounts charged by providers may not match up with the documentation you have later, and the point of sale receipts or account estimates/statements that medical providers give you when you pay before the medical insurance claim has been settled will likely not have the needed information to substantiate the claim and can cause issues with your account.
    • For example, you prepay estimated expenses of $200 for a service you received at your doctor's office. You then submit the point of sale receipt to PSA for documentation of your claim. That documentation will not be sufficient and the claim will be denied. This may cause your card to be temporarily suspended until the claim is substantiated and approved. This may cause an inconvenient delay in getting your card re-enabled or other claims reimbursed to you as EOBs and superbills can only be provided after your insurance provider has paid their portion. Also, the actual amount on the EOB or superbill may be different that the original paid amount, making substantiation and reconciling your MERP account more complicated.
    • If an over-payment to a provider occurs, request the provider refund the card rather than carry a credit on the account.
  • TIP: Probably the best tip! Your Employee Benefits Team is here to help you navigate these claims situations. We've tried to give you the best tips and information here so you can be prepared. But, when it comes down to it, this stuff can get confusing and frustrating, especially with medical expenses being high, and your family potentially navigating some medical issues, and all of a sudden your MERP debit card isn't working at the pharmacy when you were counting on it. Contact us right away if you hit any snags and we can walk you through things or get you to the right person at PSA to clear up your situation. Contact our team at employee.benefits@multco.us, or leave a voicemail at 503-988-3477.

MERP Forms

MERP Documents and Information

For general FSA plan questions and plan enrollment and change information, contact Multnomah County Employee Benefits at: employee.benefits@multco.us, or leave a voicemail at 503-988-3477.

For FSA plan online account enrollment help or access issues, claims eligibility, claims submission help, or debit card questions, contact PacificSource Administrators (PSA) customer service: call 800-422-7038, email PSACustomerService@PacificSource.com, or find answers and resources on the PSA website.

Last reviewed October 15, 2024

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