Flexible Spending Accounts

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PacificSource Administrators
541- 485-7488
800-422-7038 toll free
www.pacificsource.com/PSA
E-mail: psamembership@pacificsource.com

 

Note regarding 2016 FSA funds: 2016 eligible expenses/services can be incurred through March 15, 2017 and must submitted by June 15, 2017.

 

Elect your 2017 FSA during open enrollment! Be sure to write in the amount you want for the ENTIRE YEAR on your form.

  • Maximum election amount for 2017 Health Care FSA: $2,500 per employee
  • Maximum election amount for 2017 Dependent Daycare FSA: $5,000 per family

 

 

PacificSource Administrators Resources

 

How much should you contribute to your flexible spending account? Use PacificSource's handy expense worksheet to help you estimate.

Want to manage your account online? Create your MyFlex account to submit/view claims, submit documentation, and more.

You can also submit a claim by fax or mail using the FSA Reimbursement Form

  • Fax: (866) 446-6090
  • PacificSource Administrators
    PO Box 2797
    Portland, OR 97208-2797

Want to know more about your flexible spending account? Check out these great resources:

Other Useful Forms: