Benefits & Medical Information Home
FSA Mid-Year Plan Changes & Enrollments
April 12, 2021 through April 30, 2021
Please review the handbook before enrolling or making any changes.
To change your election or start participating in the 2021 FSA Plan, please complete the 2021 Mid-Year FSA Election Change Form. The form should be scanned and uploaded to the CBIZ (Pension Dynamics) secure website: https://secure.pensiondynamics.com/ .
Click here for the 2021 Mid-Year FSA Election Change Election Form
For plan information/clarification assistance, please contact CBIZ.
CBIZ acquired pension Dynamics; however, the same team is here to assist you with your account. You can continue to contact them directly by phone at (925)956-0514 or email at PHCBenefits@cbiz.com.
Announcement emailed April 12, 2021 below:
Important Benefits Information: FSA Plan Changes
To provide pandemic relief, recent federal legislation (the Consolidated Appropriations Act of 2021) included allowances for employers to make optional changes to Flexible Spending Account (FSA) rules. Peralta Community College District is allowing the following changes to our Healthcare and Dependent Care FSAs.
These changes are effective January 1, 2021 and will remain in effect as noted below.
Opportunity to Make Mid-Year Election Changes: April (12th – 30th), 2021
For Healthcare FSA Only
Carry Over 100% of Unused Balance
- In the past, the Healthcare FSA allowed up to $550 (as indexed for 2020) of unused funds to carry over to use in the following year; any excess balance would be forfeited. Due to the recent Act, the cap on the carryover amount has been removed. 100% of unused Healthcare FSA balances may carry over from the plan year ending in 2020 to the plan year ending in 2021 and from the plan year ending in 2021 to 2022 plan year. Carrying over a balance does not affect your enrollment for a subsequent year. You will still be allowed to contribute up to the maximum contribution limit set by the IRS.
EXAMPLE
Maria enrolled in the Healthcare FSA for 2020. She had $700 left in her account at the end of the year. She is able to carry over the entire balance to use in 2021. Maria expects higher healthcare expenses in the coming year, so she elected to contribute $2,750 to her FSA for 2021, for a total of $3,450 in her account. If she does not use that entire amount in 2021, she will be allowed to carry over all of her remaining balance to use in 2022.
For Dependent Care FSA Only
Grace Period Extended to 12 Months
- Peralta to allow the change for the 2020 plan year. The grace period is an extra amount of time after the end of the plan year that participants have to incur expenses reimbursable by the Dependent Care FSA. The grace period is being extended from 2 ½ months after the end of the plan year to 12 months after the end of the plan year with respect to unused benefits or contributions for a plan year ending in 2020.
EXAMPLE
Sam enrolled in the 2020 Dependent Care FSA for January 1 – December 31, 2020. Due to the pandemic, Sam’s child care expenses were less than he expected, and he had $1,000 left in his FSA at the end of the year. Sam may continue to use the $1,000 balance in his FSA to get reimbursed for eligible dependent care expenses incurred through December 31, 2021. Any balance remaining at the end of the 12 month grace period will still be forfeited.
Dependent Care FSA Contribution Limit
Contribution Limit Increase to $10,500 in Plan year 2021.
Dependent Maximum Age – For Dependents who “Aged Out” During the Pandemic
- The maximum age for eligible dependents is temporarily extended from “under age 13” to “under age 14”. If you participated in the Dependent Care FSA during the 2020 plan year, AND your dependent(s) turned 13 between January 1 – December 31, 2020, you may continue to receive reimbursement from your Dependent Care FSA for their eligible expenses. You may continue to use any carryover balance for their care until they reach age 14, at least through the end of the 2021 plan year.
EXAMPLE
Alex enrolled in the Dependent Care FSA for the plan year effective January 1 – December 31, 2020. He elected to contribute $2,500 for before and after school care for his daughter. The pandemic caused temporary changes in the family schedule, and Alex spent less than he anticipated on care in 2020, resulting in a $1,200 balance in his FSA. Even though his daughter turned 13 on August 11, 2020, due to the age extension, Alex can continue to use his FSA balance to pay for his daughter’s care until she turns 14 in 2021.
This email constitutes a Summary of Material Modifications (SMM) to Peralta Community College District’s Flexible Spending Account. This is merely a summary of the most important changes to the Plan and information contained in the Summary Plan Description (“SPD”) previously provided to you. It supplements and amends that SPD so you should retain a copy of this document with your copy of the SPD. If you have any questions, contact the Administrator. If there is any discrepancy between the terms of the Plan, as modified, and this Summary of Material Modifications, the provisions of the Plan will control.
Important Links
2020 Employee Open Enrollment Benefits Newsletter/Announcement
2020 Retiree Open Enrollment Benefits Newsletter/Announcement
2020 – 2021 PCCD Employee Benefits Guide with Monthly Contribution Rate Matrix
2020 – 20201 PCCD Retiree Benefits Guide
PCCD Required Documentation Matrix
Registration and login online instructions for BenefitBridge
BenefitBridge Secure Enrollment Portal
403 (b) & 457 (b) Plan Information
For BenefitBridge technical assistance only, please contact BenefitBridge Customer Care at 800.814.1862;
Mon – Fri, 8:00 AM – 5:00 PM, PST or email benefitbridge@keenan.com
For assistance with your benefits questions, please contact the District, Benefits office at 510.466.7229;
Mon – Fri, 8:30 AM – 5:00 PM, PST or email benefits@peralta.edu
Benefits Resource Libraries -Current & Previous Plan Years
*Located under the Navigation tab top left of webpage.
Current Plan year ( July 1, 2020 – June 30, 2021 ) Resource Library Below
Medical Plans
Kaiser HMO Plans
2020-2021 Kaiser Traditional Plans Summary of Benefits & Coverage
Peralta-Community-College-Kaiser-HMO-10 SBC
Peralta-Community-College-Kaiser-HMO-15 SBC
Peralta-Community-College-Kaiser-HMO-0 SBC
2020-2021 Kaiser Senior Advantage Plans Summary of Benefits & Coverage
Peralta Community College 65 HMO $0 SR ADV Benefit Summary
Peralta Community College 65 HMO $10 SR ADV Benefit Summary
Peralta Community College 65 HMO $15 SR ADV Benefit Summary
Kaiser Permanente Senior Advantage (HMO) Enrollment Form
Universal Benefit Enrollment Form – Retiree & Exceptional Processing
*Retirees enrolling in a Kaiser Permanente Senior Advantage Plan must complete the Kaiser Permanente Senior Advantage Enrollment form (above) and mail to the address on the form. If you are changing your medical plan during open enrollment also complete the Universal Benefit Enrollment Form (above) and mail to the PCCD Benefits Office at the address on the form along with any required dependent documents if applicable. Remember to enclose a copy of the Kaiser Permanente Senior Advantage Form mailed directly to Kaiser.
PCCD Kaiser Permanente Reimbursement Form
Anthem PPO Traditional & PPO Lite Self-funded Plans Administered by Trustmark
2020-2021 Summary of Benefits & Coverage
Peralta Self Funded Traditional PPO SBC $15 Plan (Local 1021 & Confidentials)
Peralta Self Funded Traditional PPO SBC $10 Plan (PFT, Management & Trustees)
Peralta Self Funded Traditional PPO SBC $15 Plan (Local 39)
Peralta Self Funded Lite PPO SBC $15 Plan (Local 1021 & Confidentials)
Peralta Self Funded Lite PPO SBC $10 Plan (PFT, Management & Trustees)
Peralta Self Funded Lite PPO SBC $15 Plan (Local 39)
Universal Benefit Enrollment Form – Retiree & Exceptional Processing
*Retirees changing medical plans during open enrollment must complete the Universal Benefit Enrollment Form (above) and mail to the PCCD Benefits Office at the address on the form along with any required dependent documents if applicable.
CASH IN-LIEU OF MEDICAL & DENTAL BENEFITS FORM
If you are an active employee waiving medical and dental benefits please uploaded the completed form with all required insurance verifications during your BenefitBridge online enrollment.
Dental
Dental PPO
Delta Dental PPO Plan – Plan Summary
UHC Dental DHMO – Direct Compensation Dental Plan
UHC DHMO – Direct Compensation Dental Plan Evidence of Coverage
UHC DHMO – Direct Compensation (DC) Contributory CA250/covered dental services CA D1065
Vision (Bundled With Medical Plans)
Kaiser Vision Plan & UHC Vision Plans – Benefits Summary
Voluntary Vision
VSP (Voluntary Vision) – Benefits Summary
District-Paid Life Insurance
District-Paid Disability Insurance
Long Term Disability Certificate
Employee Assistance Program (EAP) Administered by MHN
Flexible Spending Medical and Dependent Day Care Expenses under IRS Code 125
*Open enrollment occurs annually November 1-30 for the following plan year (January – December).
Current year forms & Documents:
CBIZ FSA Handbook with Enrollment Form- 2021
Flexible Spending SPD: 2014-spd-003
PENSION DYNAMICS FSA Claim-form Plan Year 2020
CBIZ FSA Claim-form Plan Year 2021
CBIZ Direct-deposit-authorization
CBIZ FSA Change in Status or Termination Form
Pre-tax Commuter Expense under IRS Code 132
The maximum amount you may contribute to each account cannot exceed the maximum amount specified in Code Section 132(f).
The maximum amounts are:
Parking Expenses $270/month
Transportation Expenses $270/month (Public transportation/vanpool)
CBIZ COMMUTER – Transition Guide
CBIZ Pre-Tax Commuter Handbook with Enrollment Form – 2021
Pre-Tax Commuter SPD: peralta-132-doc
PENSION DYNAMICS Pre-Tax Commuter Claim Form (Eligible expenses prior to 12/31/2020
CBIZ PRE-TAX COMMUTER (PARKING ONLY) Claim-form Plan Year 2021
*CBIZ debit card must be used for eligible transit expenses starting 1/1/2021.
CBIZ Direct-deposit-authorization
Medicare Downloads
Medicare A, B & D Premium Reimbursement Plan Summary Plan Description (SPD) 2015
Medicare-A-and-B-and-D-Premium-Claim-Form-Revised-11-24-20
Medicare Reimbursement Plan Policy Statement 10.2015
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