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Flexible Spending Accounts (FSA)

Flexible spending accounts (FSAs) allow an employee to contribute a predetermined percentage of pretax pay to an account that he or she can then use to pay for qualifying expenses incurred during the plan year (plan year runs October 1st thru September 30th). Depending on the type of FSA, those expenses might include childcare or medical costs that aren’t covered by health insurance. At the end of the plan year, new regulations have allowed for up to $570 of unused Health FSA contributions to rollover to the next plan year.

Eugene School District 4J offers two different kinds of Flexible Spending Accounts (FSA’s) and they are administered by PacificSource Administrators.  See the following links for additional details.  You can also contact PacificSource directly at (541)485.7488 or   https://psa.pacificsource.com/Flex/


Health related expenses (HRE)

You can use an HRE to pay for things like deductibles, co-insurance, co-pays, dental care, vision care and prescriptions drugs.  You have access to your entire annual election amount at the beginning of the benefit year.  You also can elect to get a ‘debit card’ also called a Benny Card, to pay for eligible expenses so that you don’t have to pay up front and then file for reimbursement later.  Visit PacificSource Administrators website to find a list of eligible expenses and to find answers to some Health Related Expenses FAQ’s HRE


The Benny™ Prepaid Benefits Card

Benny™ is a special MasterCard® that deducts charges for qualified purchases from your FSA or HRA account. You can use Benny™ at any health-related business that accepts MasterCard®.

How does it work?

  1. Charge it!
    Use your Benny™ Prepaid Benefits Card, instead of check or cash, to pay for health-related expenses at your doctor’s office or pharmacy.
  2. Check your receipt.
    Before you leave the doctor’s office or pharmacy, look at your receipt to ensure that it shows the following information:
    1.Date of service or purchase date
    2.Brief description of the item or service
    3.Patient responsibility (the amount you paid), after the insurance has paid (if they were billed)

    1. If your receipt is incomplete, ask the provider to print out a receipt showing all three pieces of information.
  3. Save your receipt.

Unlike most pharmacies, healthcare providers do not have a specialized inventory system in place that allows us to determine what you purchased. If we are unable to auto-match your purchase, we will contact you to ask for a copy of your documentation to substantiate the transaction.

Benny Card Flier

Benny Card FAQ’s



Dependent care expenses (DCE)

Each of the expenses listed below are potentially qualifying expenses. Expenses must enable the participant and spouse (if applicable) to be gainfully employed or actively looking for work.

  • After school care or extended day care programs, Agency fees (if required to obtain the related care), Application Fees (if required to obtain the related care), Babysitter (unless this is a person for whom the participant can claim a deduction on IRS Form 1040), Before-school care, Day camps (overnight camp is not eligible), Day care center, Deposits, Eldercare, Nanny, Prepaid fees for care, Preschool, Registration fees (if required to obtain the related care), Sick-child facility

Find answers to Dependent Care  FAQ’s DCE

Qualifying Events and Midyear Change Rules

FSA Change Form (Pacific Source) – This form is for mid-year changes to Dependent Care FSA only. Please return completed form within 30 days of the change. Please note that the form needs to be returned to Human Resources by the 15th of the month for changes to current month pay cycle.




Current employees can enroll during our benefit open enrollment period at the beginning of each school year.  Newly eligible employees can enroll during their initial enrollment period (first 2 weeks in benefit eligible position).  To enroll in either of the FSA programs, fill out the Flex Spending Enrollment Form and return in to the HR office during your initial enrollment period.  During open enrollment it will be online only.


To get reimbursed for qualifying out-of-pocket expenses, submit the request online at www.pacificsource.com/PSA for the fastest processing or submit the paper FSA Reimbursement form.

You can also set up to have your reimbursements direct deposited into your account by logging into your My Flex account.


Plan Documents

PSA Plan Documents 2019-20