FLEXIBLE SPENDING ACCOUNTS
•Health Care FSA•Dependent Day Care Assistance Plan
BIG SAVINGS FOR YOU!
SECTION 125 FLEXIBLE BENEFIT PLAN
The dollars you put in Flexible Spending Accounts are TAX FREE, SAVE YOU MONEY and are AVAILABLE IMMEDIATELY
Your pre-tax deductions Are Taken To Fund Your Account, Each Pay PeriodPay Period
You can Participate and Defer HEALTH CARE FSA – Up to $2,500 per Plan Year DEPENDENT DAY CARE ASSISTANCE PLAN – Up to
$5,000 if MARRIED filing jointly or Single Head of Household$2 500 if M i d fili t l• $2,500 if Married filing separately
Your Spending Account pays for eligible expenses for services that take place during the Plan Year: January 1 – December 31, each
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year
FLEXIBLE SPENDING ACCOUNTS???
NOT PARTICIPATING IN PARTICIPATING IN THE THE FLEX PLAN??
Your gross pay is taxedFLEX PLAN?
Your Annual Election d t bl All of Your Take Home
Pay is further reduced by your Out of Pocket
reduces your taxable pay!
Your net take homey yCosts
You have less spending
Your net take home pay is HIGHER
You keep more $$$$$ money in your pocket!
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BENEFIT OVERVIEW
DEPENDENT DAY CAREHEALTH CARE FSA$2,500 Annual Maximum
(Full Amount Available Day 1)
DEPENDENT DAY CARE ASSISTANCE PLAN
$5,000 / $2,500 Annual MaximumPayroll Deduction Amount OnlyPayroll Deduction Amount Only
Health Plan CopaymentsPrescriptions
Dependent Day Care Expenses incurred while you work
Prescribed OTC DrugsDental
Eligible “Tax” DependentsChildren ages 12 and underDi bl d SVision
HearingD d tibl
Disabled SpouseParents incapable of self-care
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Deductibles
YOUR HEALTH CARE FSA
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ELIGIBLE HEALTH CARE EXPENSES
Orthodontia treatment Deductibles Rx co-payments Chiropractic Contraceptive Prescriptions
Contact solutions, cleaners
D t l Contraceptive Prescriptions Psychiatrist/Counseling Durable Medical
Dental expenses Vision expenses Eye glasses,
Equipment Lasik Eye Surgery Co-insurance
Eye glasses, contact lenses
Diabetic supplies Co-insurance PPO, HMO or EPO
co-payments
Prescribed Over-the-Counter Drugs
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Health Care Reform: EligibilityR t i ti O Th C t (OTC) ItRestriction on Over-The-Counter (OTC) Items
Under the Patient Protection and Affordable Care Act and the Health Care and EducationAct and the Health Care and Education Reconciliation Act of 2010, all Over-The-Counter (OTC) drugs, medicines, and biologicals (with the exception of insulin) will be ineligible, unless prescribed by a physician as of January 1, 2011 or thereafter.thereafter.
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Please contact Medcom if you have questions!
Health Care Reform:S l Li t f O Th C t ItSample List of Over-The-Counter Items
OVER-THE-COUNTER OVER-THE-COUNTER (OTC) ITEMS REQUIRING
A PRESCRIPTION IN ORDER TO BE ELIGIBLE
(OTC) ITEMS ELIGIBLE WITHOUT HAVING A
PRESCRIPTIONO O G SC ONCough, Cold & Flu Medicines
Allergy & Sinus Medications
Insulin & Diabetic Supplies
Bandages and Splints
Pain Relievers
Anti-Diarrheal Products
Birth Control
Reading Glasses
Motion Sickness Pills/Patches
Stomach Remedies
First Aid Supplies
Wheelchairs, Crutches, etc.
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INELIGIBLE HEALTH CARE EXPENSES
Expenses that are not MEDICALLY NECESSARY are pnot eligible and may not be reimbursed from your FSA.
Following is a partial list of INELIGIBLE expenses. Always contact the MEDCOM with questions about
Cosmetic Treatments
eligible expenses.
Cosmetic Prescriptions Teeth Bleaching Herbs and Vitamin Supplements Herbs and Vitamin Supplements Over-the-Counter Drugs and
Medications without a Prescription Insurance Premiums
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Insurance Premiums
YOUR DEPENDENT DAY CARE ASSISTANCE PLANASSISTANCE PLAN
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ELIGIBLE DEPENDENT DAY CARE EXPENSESEXPENSES
Covers CUSTODIAL CARE for your eligible y gdependents as follows Children 12 or younger Day Care or Nanny expenses for Custodial Care “Before” and “After” school care for your childreny Day Camps Custodial Day Care for disabled SpouseCustodial Day Care for disabled Spouse Day Care for dependent parent(s) living with you and
incapable of self-care while you work
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p y
INELIGIBLE DEPENDENT DAY CARE EXPENSESEXPENSES
Day Care for your dependents, if you or your spouse are not working Expenses paid to a caregiver with no Social Security or Tax ID
Number E t fil d t t (Y t fil IRS F 2241) Expenses not filed on your tax return (You must file IRS Form 2241) Tuition Registration Fees Registration Fees Day Care or Babysitters after work hours Expenses incurred if your spouse is unemployed (unless a full time p y p p y (
student or disabled)There are other ineligible Expenses - Contact Medcom if you have
questions
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questions
CALCULATING YOUR PRE TAX DEDUCTIONDEDUCTION
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ANALYZE YOUR COSTS CAREFULLY (YOU WON’T LOSE YOUR MONEY)( )
REIMBURSABLE MEDICAL EXPENSESR E $25 12/ $ 300• Rx Expenses $25 co-pay x 12/year $ 300
• Physician Expenses $20 co-pay x 10/year $ 200
• Specialist Expenses $30 co-pay x 2/year $ 60
• Vision Expenses $ 240(1 set of glasses/exam)
• Dental Expenses $ 200(1 C @ 40% i )(1 Crown @ 40% coinsurance)
Total Reimbursable Medical Expenses $1,000
B. REIMBURSABLE DEPENDENT CARE EXPENSES• Monthly Expense $100 x 10 $1,000
C. TOTAL FSA & DAY CARE EXPENSES $2,000
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GENERAL TAX SAVINGS EXAMPLETAX SAVINGS EXAMPLE
Without FLEX With FLEX
Gross Annual SalaryGross Annual Salary $26,000 $26,000Health FSAHealth FSA 0 - 1,000Dependent Day Care 0 - 1,000Dependent Day Care 0 1,000Taxable Salary $26,000 $24,000Less FICA & Federal Tax -$4,520 -$3,994Take Home Pay $21,480 $20,006Out of Pocket Medical / Day Care -2,000 0Net Take Home $19 480 $20 006Net Take Home $19,480 $20,006SAVINGS $ 526
The above tax savings are understated. Your actual savings will vary depending on your
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The above tax savings are understated. Your actual savings will vary depending on your salary, filing status, state tax savings, etc.
MEDCOM’S FSA/DCAP DEBIT CARDHELPS YOU USE YOUR MONEYHELPS YOU USE YOUR MONEY
•Technically, a “Stored Value” card•For Health Care FSA and DCAP •Typically, a 3-year period of activationTypically, a 3 year period of activation•“24/7” access to transaction and balance info
www.emedcom.netW lthC O li / dwww.myWealthCareOnline.com/medcom
•“24/7” telephone IVR access to balance info800-523-7542
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TRACK TRANSACTIONS AND ACCOUNT BALANCES ONLINE
Presenting the New and Improved Medcom Benefits Portal
BALANCES ONLINE
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MEDCOM’S NEW WEALTHCARE ONLINE PORTALPORTAL
New Features and Conveniences: New Features and Conveniences: Easy-to-navigate user interface
E h d t d t il Enhanced account details Easily update personal and dependent info Submit claims online Upload receipts to substantiate transactions
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RECEIPT SUBSTANTIATION
Debit Card Transactions Where a Receipt Will Not be Requested
Exact Copayment Match with Group Medical PlanRepetitive Medical FSA Transaction
Same Dollar Amount, Same Provider Initial documentation must be filed with Medcom
FSA Purchases at Drugstore comFSA Purchases at Drugstore.com A special “FSA Store” stocked with eligible items
OTC and Rx Purchases atand stores,
and also at many similar independent merchantsRECEIPTS are Requested for ALL OTHER Transactions
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RECEIPTS are Requested for ALL OTHER Transactions
NO “PIN” NO “ATM”
Your Card is NOT eligible for use at Your Card is NOT eligible for use at ATM’s
Must only be used at health or day care related providers such ascare related providers, such as Hospitals Physician offices
D l ffi Dental offices Vision Service providers Pharmacies Daycare Centers
The purchase will be denied at point of sale if unauthorized use is attempted
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p
USING YOUR DEBIT CARD
SWIPE to pay for eligible Health FSA expensesPIN can be used (must be obtained from the web portal)Card transactions immediately post for paymentKEEP ALL RECEIPTS for all transactionsKEEP ALL RECEIPTS for all transactionsEXACT copay, SKU-filtered, or pre-approved recurring transactions
Automatically approve Complete and return a RECURRING EXPENSE FORM to
establish 1st recurring claimRECEIPTS are requested for ALL OTHER transactionsSufficient response submitted – “Transaction Approved!” FAX Receipt Request Letters WITH RECEIPTS to Medcom
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DEBIT CARD – INELIGIBLE EXPENSES
IRS requires taxes to be paid on ineligible expenses
Ineligible expenses are considered a debt owed to the Flex Plan and must be repaid
Funds may be used for other eligible expenses Funds may be used for other eligible expenses
If ineligible expenses not repaid
Card deactivated
Paper claims required
• Paper claim Offset by ineligible expense, or
• Payroll Deducted by Employer
• Employee W2, if ineligible expense not collected
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collected
PAPER CLAIMS
HEALTH FSAi l d E l ti f B fit f i i include Explanation of Benefits from your insurance carrier, co-payment receipts or medical statements with service date(s), out of pocket costs, item or service description.
DAY CARE DAY CARE attach receipts for expenses including the provider’s name and tax
ID number or social security number, dates of service and cost of carecare
RECEIPTS MAY NOT INCLUDE - Cancelled Checks, Credit Card Receipts, Balance-Due Statements
FILING DEADLINE Cl i INCURRED DURING PLAN YEAR FILING DEADLINE – Claims INCURRED DURING PLAN YEAR –Employees have 90 days following the end of the Plan Year to submit claims on expenses already incurred
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ENROLL TODAY!
CALCULATE YOUR HEALTH FSA AND DAY CARE ELECTION
COMPLETE AN ENROLLMENT FORM AUTHORIZING DEDUCTIONS
ORDER A DEPENDENT CARD IF APPLICABLE ORDER A DEPENDENT CARD, IF APPLICABLE
YOUR ELECTION CAN NOT BE REVOKED UNLESS YOU HAVE A QUALIFIED FAMILY STATUS CHANGE
M i l h Marital status change Number of dependents Employment status Dependent loses or gains eligibilityDependent loses or gains eligibility
ENJOY YOUR TAX SAVINGS!!!
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CONTACT US
Mailing AddressMedcom Flex Division
P O Box 10269P O Box 10269Jacksonville, FL 32247-0269
Office 904.596.4500T ll F 800 523 7542Toll-Free 800.523.7542Fax 877.723.0149
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