I never used the Flex Spending even though I had it available to me. I just didn't like the "use it or lose it" deal and guess was too stupid to really look at it closely enough. However, our company now offers a Health Savings Account (HSA) plan and I'm one of the few on the plan in my company. It's coupled with a high deductible (in my case $2,200 for my wife and myself which I believe is the min to qualify) which you have to meet before anything is covered. Once you meet that deductible though everything is covered at 90% (All of this is in-network). Preventative Health Care (Annual physicals, diagnostics, etc.) is covered 100% from the get go. Then there is the actual HSA. My company actually covers half of the Deductible by paying it to our HSA in two installments, January and June (so $1100/year). I deposit the enough into my HSA so that by the end of the year I've put in the other $1100 into the HSA so I know I'll be covered for my deductible. And, when you add my premiums and my HSA contributions together, I still end up paying LESS than the premiums for the standard PPO plan our company offers.
If I don't meet the deductible at the end of the year, everything just stays there. No disappearing cash, AND it actually earns 4% interest! And it's all pre-tax.
You wouldn't believe how HARD it is to convince people that this plan is a good idea. All because of the fact that you have to pay 100% until you meet your deductible. Never mind that you are paying for that deductible with pretax dollars that come out of your HSA account with a dedicated ATM/Credit card. Never mind that you pay less in premiums. All most people care about is that they pay that $20 (or whatever) co-pay instead of let's say $80 for that office visit, or $7 or $25 for that prescription instead of $50-$100+. Oh, and Prescription Drugs count towards your deductible as well. Hell, it doesn't even matter when I explain to people that the company is basically paying them to use this plan by subsidizing their HSA account with half the amount of their deductible. It doesn't help that the people "selling" the plan every year in our yearly Health Insurance meetings suck at it, but still.
Obviously, all the details above are specific to my plan and not all plans are the same, some are not as good. Further, I do realize that for some people the above plan is not the best option...just that it IS for alot more people than think so.