Appdx H_Definitions.docx

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Federal Flexible Spending Account (FSAFEDS) Program Services
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24361820R0002
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I. DEFINITIONS

The following definitions are only for the purpose of this Request for Proposal, and its attachments and appendices.

Adopting Employer
The Executive Branch of the Federal Government. Adopting Employer also means an Employer that signs an adoption agreement, accepted by OPM, to participate in this Plan. An Employer remains an Adopting Employer until the Plan terminates, the Adopting Employer withdraws from the Plan, or OPM terminates the Adopting Employer’s participation in the Plan.
Agency(ies)
Departments and independent agencies of the Federal Government, including the Tennessee Valley Authority, but not including the D.C. Government.
Allotment
Also called an election. The total amount of pre-tax gross income a participant puts into their FSAFEDS flexible spending account for the benefit period.
Annuitants
Federal retirees (who retired on an immediate annuity), and survivors (of those retired on an immediate annuity) receiving annuity compensation. Also includes those receiving compensation from the Department of Labor. Sometimes called retirees.
BC
Benefits Counselor. Also called a Customer Service Representative or CSR.
BENEFEDS
An enrollment and premium administration portal contracted by OPM
Contractor
Depending on context may refer to any entity that is part of the bid on this request for proposal, or it may refer to the “winning” entity that we sign a contract with. Same as carrier, offerror, or offeror.
Contracting OfficerComment by Belanger, Shireen M.: These are defined by FAR and we will use the FAR definitions
The OPM employee who has the authority to bind the Government under the resulting contract with the Contractor.
Covered Employee
Under FedFlex, means an individual who is an employee under Section 2.9, is employed by an executive branch or Adopting Employer, and satisfies coverage requirements under Article 3.
CSR
Customer Service Representative. Also called BC.
DCFSA
Dependent Care Flexible Spending Account
EFT
Electronic Funds Transfer.
Election
Also called an allotment. The total amount of pre-tax gross income a participant puts into their FSAFEDS flexible spending account for the benefit period.
Employee
Under FedFlex, for purposes of the Health Care Flexible Spending Account, and no other purpose, an employee is as defined in 5 USC section 8901(1); except that Employee does not include: employees of the judicial branch; employees of the District of Columbia government; or employees not eligible to participate in the FEHB Program in accordance with applicable statutes and regulations; or a Reemployed Annuitant.

For purposes of the Dependent Care Flexible Spending Account, and no other purpose, an employee as defined in 5 USC section 8901(1); except that Employee does not include: employees of the judicial branch; employees of the District of Columbia government; or a Reemployed Annuitant.

Employee Express
A portal used by some agencies that allow employees to initiate the processing of their discretionary personnel-payroll transactions electronically.
Employer
Any Agency whose employees are eligible to elect a health care and/or dependent care FSA under the Federal Flexible Benefits Plan (FedFlex). In the case of an employee whose payroll office is not an Executive Branch payroll office, the employer is the entity that issues pay on behalf of the Employee.
FEDVIP
Federal Employees Dental and Vision Insurance Program
FEGLI
Federal Employees' Group Life Insurance
FEHB
Federal Employees Health Benefits
FLTCIP
Federal Long Term Care Insurance Program
FSA
A health care or dependent care Flexible Spending Account, as allowed by Internal Revenue Code Section 125.
FSAFEDS
The Federal Flexible Spending Account Program offered to eligible employees of an employer, as determined by OPM.
GAO
United States Government Accountability Office
Grace Period
An additional 2 ½ months (January 1 through March 15) during which FSAFEDS participants can incur eligible expenses that can be reimbursed from the prior year balance.
HCFSA
Health Care Flexible Spending Account
HIPAA
Health Insurance Portability and Accountability Act
IPAC
Intra-Governmental Payment and Collection
IVR
Interactive Voice Response System
LEX HCFSA
Limited Expense HCFSA. A LEX HCFSA is considered to be an HCFSA.
LTC
Long term care
OPM
United States Office of Personnel Management. Also referred to as ‘we’.
Paperless Reimbursement (PR)
The process by which participating FEHB and FEDVIP carriers regularly submit claims data to the Contractor on behalf of their FSAFEDS-participating members. The data includes all information required by the Contractor to process a health care FSA claim, including date of service, type of service, and patient out-of-pocket liability. The Contractor uses this data to automatically adjudicate claims and reimburse health care FSA participants for eligible expenses without the need for the participant to submit a manual claim.
Plan Agent
A third party administrator under contract to OPM to provide designated administrative services with regard to the Plan.
Plan Year
A 12-month period ending on each December 31. The plan year may be extended 2 ½ months by a grace period in some situations.
PHPM
Per HCFSA Per Month
PMPM
Per Member Per Month
Qualifying Life Event
Also called a QLE. An event defined by the Internal Revenue Service in Internal Revenue Code, Section 125 that allows participants to change their flexible spending account election outside of the annual Open Season.
Reemployed Annuitant
An individual who is retired from the Federal Government, is reemployed as an employee as defined in 5 USC 8901(1), and who continued to receive an annuity.
Risk Reserve
OPM’s FSAFEDS funds
SOB
Summary of Benefits
We
United States Office of Personnel Management
You
The Contractor or Offeror

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