Please Log In as the Human Resource Administrator to view monthly reports. Once logged in, please click on the icon on the right side of the screen which looks like a pencil and paper and says “View Your New Documents”.

At this time our website does not give decline history on the Employer View of the website. Please call our office and we will be happy to assist you.

Please complete the Change in Status Form or send an email to your personal representative to notify us of a termination.

Options/information on Leaves:
OPTION 1: When it is unknown if missed contributions will be made up, or if it is known missed contributions will not be made up:
The effective leave date would be communicated to us via the Change in Status Form. We would put them on leave in the system and reduce their election to the amount that has already been contributed. When they return to work, the effective return date would be provided to us again via the Change in Status Form.
a. If upon return, the employee chooses not to make up the contributions that were missed during their leave, they would have a black out period during their leave period (based on the effective dates provided to us). Any dates of service incurred during their leave would not be eligible for FSA use. The employee would then continue their contributions upon return and the annual election would be reduced by the number of pay periods missed.
b. If upon return, the employee chooses to make up contributions that were missed, the annual election would revert back to their original annual election and there would not be any blackout dates for FSA use. The FSA would run as normal.

OPTION 2: When it has already been determined missed contributions will be made up when the employee returns: There is no black out period and the FSA would run as normal. However, because the full FSA Medical election is available day one of the plan year, an employee could agree to making up contributions when they return from leave (and thus no black out period), use their FSA funds, but then not return to work as expected. They could potentially use more than they’ve contributed and leave their account at a negative balance.

An employee can elect to add the Dependent Care Account mid-year if they did not have dependent care expenses at the beginning of the year, but then have them begin mid-year due to the birth or adoption of a child as well as a child starting to attend a day care facility.

When an employee elects coverage under a cafeteria plan, the employee must maintain that coverage until the end of the Plan Year unless the employee experiences one of the following events:
1. Change in Status
• Change in employee’s legal marital status
• Change in number of dependents
• Change in employment status or employee, spouse, or dependent that affects eligibility
• Dependent satisfies (or ceases to satisfy) dependent eligibility requirements
• Change in residence of employee, spouse, or dependent
• Commencement or termination of adoption proceeding
2. Small Cost Changes – Premium Only Contribution Only
3. Significant Cost Changes– Premium Only Contribution Only
4. Significant Coverage Curtailment– Premium Only Contribution Only
5. Addition or Elimination of Benefit Package Option– Premium Only Contribution Only
6. Change in Coverage for Spouse/Dependent under Other Employer’s Plan
7. FMLA Leave
8. COBRA Events
9. Judgment, Decree, or Order
10. Entitlement to Medicare

If a participant wishes to change an election based on a Change in Status, the change must be consistent with the Changes in Status as follows:
For accident and health benefits (such as health, dental and vision coverage), coverage changes are generally not allowed unless there has been a gain or loss of coverage eligibility
For group term life insurance and disability and dismemberment coverage, changes can be made following a change in status event even if coverage eligibility has not been affected.

For Health FSAs, it is more difficult to change elections. No elections are permitted for a change in cost or coverage of other health benefits. Election changes are only allowed in the event of a HIPAA special enrollment, FMLA leave, COBRA event, gain/loss of Medicare/Medicaid eligibility or a judgment, decree, or order requiring coverage to be added or obtained elsewhere.

For DCAPs, election changes are more liberal. They can be made if coverage eligibility (or eligibility for the dependent care tax exclusion) has been affected; day care providers have been changed, or costs have changed.

Claim denial reasons are only available for the employee to view online. If you would like to know the reason for the denial, please call our office and we will be happy to assist you.

There are three ways in which an employee can pay back a card swipe:
1) Submit substantiation for the expense (if expense wasn’t deemed ineligible).
2) Submit a claim for another eligible expense that you paid for out of pocket in excess of the original card swipe.   This will clear the transaction and reactivate the card. We will reimburse the employee via check or direct deposit for any part of the expense that was in excess of the amount that was owed.
3) The employee can log in to their personal account and reimburse the employer online. This can be accomplished by going to the MYSOURCE CARD tab at the top of the screen and then choosing REPAY EMPLOYER from the toolbar on the left hand side of the screen.

Debit Cards typically arrive within 10-14 business days from the date it was ordered.

Please email your reports to

Because orthodontia is an ongoing expense (which often spans more than one plan year), it typically cannot be reimbursed all at the beginning of treatment. The expense is considered “incurred” on the date of the monthly treatments. All first time orthodontia reimbursement requests must include the Truth in Lending Statement or treatment contract from the orthodontist. This document would include: provider of service, patient name, total cost of service, cost covered by insurance, down payment (if applicable), length of treatment, monthly payment amount, as well as the beginning and ending date of monthly premium payments. The amount of the monthly payment can be reimbursed only on a month to month basis as treatment happens. We cannot reimburse for monthly payments in advance.
LUMP SUM PAYMENT: If you pay for the entire orthodontic treatment up front, we can reimburse you on a prorated basis if treatment goes into another plan year. You must still submit the Truth in Lending Statement and documentation showing that treatment has been paid in full. For example: Your FSA plan year starts on January 1, 2017 and your child has braces put on in March of 2017 with treatment lasting for 18 months. The total treatment cost is $3,000.00. We would take the $3,000.00 and divide it by 18 to come up with a monthly total of $166.67. Since there will be 10 months of treatment in 2017 (March – December) we would reimburse you $1666.70 up front when treatment starts in March. In order to be reimbursed for the remaining $1,333.30, you must participate in the plan the following year and request the reimbursement in January of 2018. We will keep your documentation on file so you will only need to submit a Request for Reimbursement.
ADULT ORTHODONTIA: Adult orthodontia is not eligible for reimbursement unless it is considered medically necessary. In order to be reimbursed for adult orthodontia a letter of medical necessity must be included with the claim submission. Adult orthodontia for cosmetic purposes is not eligible for reimbursement.

Step 1: Log in to our website as the Human Resource Administrator.
Step 2: Select the Tab at the top of the screen that looks like the Debit Card
Step 3: Select the STATEMENTS option (located in the center row of options below the Account number)
Step 4: Select the month you wish to view. Each month has its own statement.