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COUNTY OF
SANTA CRUZ
HEALTH CARE FLEXIBLE
SPENDING ACCOUNT
Health Care FSA
 Employee-funded account for the
reimbursement of expenses not covered
by insurance
 Pre-tax funding of elective contributions
for known, budgetable expenses
 $2,400 plan year maximum benefit
election
 Uniform Coverage Rule: full benefit is
available on any day of the Plan Year
Health Care FSA
• Claims Administrator: Creative Benefits,
Inc.
• www.crbenefits.com
• Internet access to claims status and
account balances
• Direct Deposit of claim payments is
available
• Optional Health Care FSA Payment (Debit)
Card
- Additional $14.40 annual fee
- Annual fee for the Payment Card is
deducted from the participant’s FSA
account in January
Health Care FSA
 Eligibility for participation in the FSA:
- Employees in permanent, budgeted
positions, and employees in positions
defined as limited term
- Employees do not have to be covered in
any of the County’s group insurance plans in
order to participate in the Health Care FSA
- Dependents must meet IRS definitions in
order for their expenses to be covered
Health Care FSA
Example of Estimated Tax Savings
PRE-TAX
AFTER-TAX
ANNUAL SALARY
$50,000
$50,000
FSA CONTRIBUTION
$1,200
$0
NET TAXABLE SALARY
$48,800
$50,000
20%
20%
$9,760
$10,000
OUT-OF-POCKET
HEALTH CARE COSTS
$0
$1,200
NET ANNUAL SALARY
$39,040
$38,800
TAX PERCENTAGE
PAYROLL TAXES
Health Care FSA
EXAMPLES OF
ELIGIBLE EXPENSES
EXAMPLES OF
INELIGIBLE EXPENSES
Services provided by a
licensed health care
practitioner
Provider Co-Pays,
deductibles, RX Co-Pays
Over-the-counter medicines
and supplies
Eye glasses, contact lenses
and solutions, LASIK
Dental and Orthodontic
expenses
Vitamins and dietary
supplements
Cosmetic surgery or
procedures
Athletic or health club
memberships
Teeth whitening
Health Care FSA
 Expenses have to be incurred during
the Plan Year (January 1 through
December 31)
 Plan Year is extended 2 ½ months
into the next Plan Year for eligible
expenses to be incurred
 Claims incurred from 1/1/08
through 3/15/09 can be reimbursed
from the 2007 Health Care FSA
account if a surplus exists at the
end of the plan year on 12/31/07
Health Care FSA
•
eligible expenses will be reimbursed from
the prior year’s balance first, then from the
current year’s balance
•
all expenses that are to be reimbursed
from the 2007 Plan Year’s election must be
submitted by 3/31/08
Un-reimbursed contributions are forfeited
by the plan participant


Receipts must be provided to Creative
Benefits for all expenses
Flexible Benefit Plan
Employee Enrollment
Health Care FSA enrollment cannot be
changed during the plan year without a
qualified status event:
•Death / divorce / legal separation
•Marriage
•Change in number of dependents
•Change in employment status
TAX CALCULATOR
TAX CALCULATOR
TAX CALCULATOR
password: creative
TAX CALCULATOR
password: creative
COUNTY OF
SANTA CRUZ
HEALTH CARE FLEXIBLE
SPENDING ACCOUNT