Transcript Flexible Spending Account - Kellogg Community College

2015
Dental and Vision Plan
Flexible Spending
Account
Dental Benefits
BENEFIT
BENEFIT DESCRIPTION
CLASS A, B AND C EXPENSES COMBINED CALENDAR YEAR
MAXIMUM BENEFIT
(Subject to Usual and Customary Charges)
$1,100 per Covered Person
Class A-Preventive Services
Example: (routine oral exam)
80%
Class B-Basic Services
Example: (x-rays, simple extractions)
80%
Class C-Major Services
Example:(dentures and bridges)
50%
CLASS D ORTHODONTIC LIFETIME MAXIMUM BENEFIT
(Coverage is provided only for Covered Persons under age 19)
$1,500 per Covered Person
Class D-Orthodontic Services
(Coverage is provided only for Covered Persons under age 19)
50%
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Vision Benefits
$355.00 per Calendar Year per Covered Person
Benefit can be used for:
 Eye exam,
 Lenses (including contact lenses) and
 Frames
Dependent Eligibility
Dental & Vision
Coverage for unmarried dependent child(ren) ages 19-25 will
be available through calendar year of attaining age 25.
(Example: Turn 25 in July, coverage until December 31)
Dependent child(ren) over 19 must be a full time student.
Orthodontia coverage will be available to covered person
under age 19.
What is a Flexible Spending Account (FSA)?
A tax-effective, money-savings option that will help you pay for
qualified health care expenses that aren’t covered by your
medical plan, and for dependent care services.
Funds are deducted pre-tax from your employer pay check.
These are pre-tax dollars so they help save money
(approximately 25% in tax savings when deducted from your
paycheck pre-tax)
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What
a Flexible
Spending Account (FSA)?
What is
is an
FSA?
Kellogg Community College offers you an opportunity to
participate in two Flexible Spending Account Programs:
Healthcare FSA or Limited Healthcare FSA (if you have
an Health Savings Account)
Dependent Care FSA
FSA for Healthcare
Health Care Spending Account (HCSA)
 For healthcare expenses if you do not have a
Health Savings Account (HSA)
 Maximum amount you can contribute is $2,500 per year
 Can be used for most medical expenses not covered by
your health plan including:
Deductible, coinsurance, copays, prescription drugs,
dental, vision, hearing and orthodontic care. Certain over-thecounter medications qualify too.
Limited Flexible Spending Account
If you have a Health Savings Account (HSA), the Flexible
Spending Account is limited or restricted to:
 Dental expenses
 Vision expenses
 Medical and prescriptions only AFTER the high
deductible HAS BEEN MET.
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FSA for Dependent Care
IRS
allows
$5,000
Maximum amount you can contribute is $5,000 per year
Expenses are eligible for child care under age 13 or elder
care for IRS dependents.
Tax ID or Social Security Number and receipt are required
Reimbursable only after services have been incurred and
money has already been deducted from payroll.
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Maximize Your Savings Potential
Plan carefully! The amount of money you want to contribute to
your FSA accounts are elected in advance.
If you underestimate, you may deplete your FSA before
the end of the year, losing so of your tax-savings.
If you overestimate, you risk forfeiture of any unused FSA
funds. KCC allows you to roll up to $500 from the previous
plan year.
Mid-year election changes are not allowed without a qualifying
event! (work hours reduced, birth, death, divorce)
How to receive reimbursement
Submit
early!
Submit a complete and signed FSA reimbursement form with
these attachments:
- A copy of the Explanation of Benefits (EOB)
OR
- A receipt for co-pays and an itemized cash register receipts for OTC items
that do not contain a medicine or drug
OR
- Effective 1/1/2011, for OTC items containing a medicine or drug, an
itemized cash register receipt as well as a doctor’s prescription
OR
- An itemized statement from your healthcare provider if you don’t have
insurance coverage (for example, dental or vision services).
Direct Deposit
Fast
and
easy!
Signing up for direct deposit is a fast and easy way to be
reimbursed on expenses.
When you submit a claim for reimbursement, the funds will
be directly deposited into your checking account.
Use the direct deposit form to sign up.
Return the form via the fax number or mailing address on
the form.
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FSA Reminders
 The Patient Protection and Affordable Care Act of 2010
changed the rules for the purchase of Over The Counter
(OTC) products.
 As of January 1, 2011, FSA, HRA and HSA funds can no
longer be used to purchase OTC medicine and drugs unless
such medicine or drug is prescribed by a doctor.
 Some eligible OTC items include:
Bandages without antibiotic ointments, thermometers,
hot/cold packs, rubbing alcohol, splints, etc.
This is only a partial list. Refer to your FSA materials, contact
Meritain Health or visit www.irs.gov.
IMPORTANT DEADLINES
Plan
Incur Expense
Submit Claim
Health Care
Account
12/31/2015
2/28/2016
Dependent Care
Account
12/31/2015
2/28/2016
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Questions?
Email: [email protected]
Questions about your account.
Web: www.mymeritain.com
Check status of a claim, FSA Balances, EOB’s
Call: Meritain customer service 800-748-0003
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