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Flexible Spending Account (FSA) Open Enrollment

November 1 – December 9, 2021, for changes effective January 1, 2022.

New IRS limits and OE deadline extended to December 9, 2021.

It’s that time of the year again to enroll in a healthcare or dependent care FSA for 2022. Starting this Open Enrollment, you will need to re-elect your Commuter Benefits effective January 1, 2022, for the plan year 2022.

For 2021*, the maximum amount that you can contribute are:

· $2,850 for healthcare/medical FSA

· $5,000 (per household) for dependent care FSA

· $280 each for commuter benefits (transit and parking)

*2022 IRS contribution limits were released November 10th, 2021

What is a Flexible Spending Account (FSA)?

An FSA is a personal expense account that works with your District health plans, allowing you to set aside a portion of your salary pre-tax to pay for qualified medical and dependent care expenses. The dollars you set aside can pay for eligible expenses for you, your spouse, and eligible dependents.

How does it work?

Estimate your annual election – During your online enrollment, use the FSA calculator to estimate your expenses for the plan year and come up with how much your annual election should be.

Deductions will be taken out of your paycheck – Your annual election amount will be evenly deducted pre-tax from your paycheck throughout the plan year.

- Healthcare FSA: You cannot change your annual election amount after the plan start unless you have a qualified change in status.
- Dependent Care FSA: You can change your elections if you have a qualified change in status, there is a significant cost change or a change in coverage.
- Commuter Benefit – For the Commuter Benefits Accounts, the participants may change their deduction amount as often as monthly. Changes MUST be submitted to the Employer prior to the beginning of the month.

Access your funds – you can use your CBIZ Benefit Card to pay for your qualified expenses. You can see a more comprehensive list on our website at https://myplans.cbiz.com. Click on Tools & Support, then go to Quick Links to Health Expense Table.

How to Enroll

Enrollments are done online by visiting https://myplans.cbiz.com. Refer to the FSA Online Enrollment Instructions for step-by-step instructions on how to complete your enrollments for 2022.

Handbooks & Enrollment Instructions

Section 125 / Flexible Benefit Plan (Plan) Employee Handbook. Valid for plan years on or after January 1, 2022

Section 132/Pre-Tax Commuter Expense Program Employee Handbook. Valid for plan years on or after January 1, 2022.

Flexible Spending Online Enrollment Instructions.

FSA Open Enrollment Email Announcement

For Assistance

For assistance with your Flexible Spending Account questions and Online Enrollment, please contact

the CBIZ Service Center at 800.815.3023, option 4, or email cbizflex@cbiz.com.

For employee eligibility and plan questions, please contact the District, Benefits office at 510.466.7229
or email benefits@peralta.edu

Plan Year July 1, 2021 – June 30, 2022

Important links

2021-2022 PCCD Employee Benefits Guide with Monthly Contribution Rate Matrix

Open Enrollment 2021-2022 Virtual Presentations, Videos & Materials

Registration and login online instructions for BenefitBridge

BenefitBridge Secure Enrollment Portal

PCCD Required Documentation Matrix

403 (b) & 457 (b) Plan Information

Voluntary Benefits

Medical Plans

Kaiser HMO Plans

2021-2022 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

Click here for additional information

2021-2022 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

Click here for additional information

2021-2022 Kaiser Senior Advantage HMO Delta Dental Plan Summary of Benefits & Coverage

KPSA HMO Delta Dental Plan Summary

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

Kaiser Reimbursement Form

Anthem PPO Traditional & PPO Lite Self-funded Plans Administered by Trustmark

2021-2022 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)

Click here for additional information

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.