Section 125 / Flexible Benefit Plan EMPLOYEE HANDBOOK Plan Year: January 1, December 31, 2017

Transcription

1 PENSION DYNAMICS C O M P A N Y L L C Yur Online Enrllment Perid is Nvember 1 Nvember 30, 2016 Peralta Cmmunity Cllege District Sectin 125 / Flexible Benefit Plan EMPLOYEE HANDBOOK Plan Year: January 1, December 31, 2017 Wrking tgether t build yur tmrrw Administered by Pensin Dynamics Cmpany LLC 2300 Cntra Csta Blvd., Suite 400 Pleasant Hill, CA Phne: Fax: Click here t dwnlad the new Emplyee User Guide fr the Participant Prtal A benefit pprtunity fr the emplyees f Peralta Cmmunity Cllege District, perating under Sectin 125 f the Internal Revenue Cde

2 Abut This Handbk This Handbk is a brief descriptin f the terms f the Plan in cmmn language designed t describe the highlights f the Plan. It is nt meant t replace the Plan Dcument r Summary Plan Descriptin (SPD) which are n file with yur Plan Administratr. If yu wuld like a cpy f either f these dcuments please request ne frm yur Human Resurces (HR) Department. The Plan Dcument gverns in the event f any discrepancy between these dcuments. What Is A Flexible Benefit Plan and Hw Will The Plan Benefit Me? A Flexible Benefit Plan, als knwn as a Sectin 125 Plan, is part f a cafeteria plan that allws emplyees t purchase certain benefits with pre-tax dllars. This plan is put int place t assist in paying fr Cmpany Spnsred Grup Insurance Premiums as well as allwing yu t put aside an elected amunt fr Flexible Spending Accunts (FSAs). If yu elect t participate in any f the accunts listed in this Handbk, yu will save Federal, State, Scial Security and Medicare taxes n every dllar cntributed t the plan. Fr mst peple in the state f Califrnia, that means a savings f 30-40% n every dllar put int this plan. Enrllment in these plans will reduce yur reprtable incme; therefre yur Scial Security Benefits/Disability may be affected by yur electin. Hwever, mst will find that the tax savings far utweigh the ptential negative impact. Why Shuld I Participate? Yu wuld participate in the FSA plan in rder t pay less in taxes and have mre spendable incme! Here is an example f hw yu can save if yu elect these benefits. Withut Flex With Flex Mnthly Base Salary $3, $3, FLEX Cntributin (0.00) (500.00) Adjusted Taxable Incme 3, , Federal Withhlding (342.00) (267.00) State Withhlding (91.00) (59.00) Scial Security Tax (186.00) (155.00) Medicare (43.50) (36.25) CA SDI (36.00) (30.00) Subttal $2, $1, Expenses Cmpany spnsred Insurance Premiums/mnth (50.00) Paid (FLEX) Health Care FSA/mnth (150.00) Paid (FLEX) Daycare/mnth (300.00) Paid (FLEX) Spendable Incme $1, $1, Mnthly increase in persnal spendable incme is $ This translates int an annual take hme increase f $1, Fr many f us, this is equivalent t a $2,500 (taxable) annual salary raise. The first step tward a full appreciatin f the pprtunity prvided by the Flexible Benefit Plan is t gain an understanding f hw the gvernment taxes yur incme. Remember the last time yu received what was suppsed t be a $100 pay raise? Yu prbably nticed that yur take hme pay increased by nly abut $65. The reasn the increase was s small cmpared t yur grss wage increase was because the raise was the last $100 f yur incme and was taxed at the highest rate yu pay. This is referred t as yur Marginal Tax Rate. We have a calculatr available 2

3 n ur participant prtal at click n Resurces. Instructins n hw t register fr ur website are included in this Handbk. Once lgged int yur accunt, click Resurces/FSA Resurces/FSA Tls & Calculatrs. Frm that screen yu can click n Hw Much t Cntribute t calculate yur savings. Annual Expenses Wrksheet This wrksheet will help yu estimate yur annual medical and dependent care csts. Check the fllwing list t identify expenses that pertain t yu. This list is nt intended t be cmprehensive, but it cntains sme f the mre cmmn health care and dependent care expenses. Please refer t the page in this Handbk titled Eligible Expenses fr Yur Health Reimbursement Accunt fr a partial list f qualifying expenses. Remember t be cnservative when calculating yur electin and list nly expenses nt cvered by yur insurance. Be aware that these plans have a use r lse clause and in sme cases unclaimed amunts at the end f the Plan Year will be frfeited back t yur Emplyer. This is discussed later in this Handbk. Qualifying Daycare Expenses Estimated Annual Expense Amunts paid t a daycare center $ Amunts paid fr daycare inside yur hme $ Subttal $ Qualifying Health Expenses Estimated Annual Expense C-payments and deductibles $ Mental health cunseling, chirpractic and acupuncture $ Prescriptin drugs $ Over-the-cunter drugs and medicatins* $ Labratry fees, annual check-ups, X-rays, hspital fees $ Orthdntia and ther eligible dental services $ Prescriptin glasses, eye exams, cntacts $ Subttal $ Ttal Annual Expenses $ Nte: Qualifying expenses under Cde Sectin 125 are different frm thse listed in I.R.S. Publicatin 502. cnsult Pensin Dynamics if yu have any questins as t what cnstitutes an eligible expense. Please *Over-The-Cunter Drugs and Medicatins nly qualify fr reimbursement under a Flexible Benefit Plan if they are primarily used fr the treatment f a medical cnditin, injury, r illness. Due t Health Care Refrm, prescriptins are required fr ver-the-cunter drugs and medicatins. Hw d Flexible Spending Accunts wrk? The FSA accunts have tw ptins, the Health Expense Reimbursement Accunt and the Dependent Daycare Reimbursement Accunt. Yu can elect either r bth as needed. The amunt yu elect will be deducted frm yur pay n a pre-tax basis in equal amunts ver the number f pay perids in the Plan Year. Each year yu must elect yur FSA benefits again. The amunt yu elect at that time will remain in effect fr the entire Plan Year unless yu have a qualified change in status (described in mre detail later in this Handbk). 3

4 When d I becme eligible t participate and hw d I enrll in the plan? Once yu meet the eligibility requirements fr yur emplyer health insurance benefits yu autmatically qualify t participate in the Flexible Benefit Plan. Once yu are eligible t participate yu will have 30 days t cmplete the enrllment frm and return it t yur Human Resurces representative. Yur enrllment begins the date the frm is signed and/r the first day f yur eligibility, whichever is later, s it is better t cmplete the frm sn. Yu will nt be able t submit expenses incurred prir t the enrllment date. After enrlling we recmmend lgging int ur prtal at pensindynamics.cm/lgin t mnitr yur accunt details and balance at least mnthly. Fllwing yur initial enrllment perid, there will be an pen enrllment perid befre the start f each plan year fr yu t re-enrll. This benefit des need t have a psitive electin each plan year. What are yur Privacy Plicies and wh is authrized t btain infrmatin regarding my accunt? Yur privacy is imprtant t us and as a result we have a strict plicy in place t safeguard yur accunt and yur private infrmatin. Yu can grant yur spuse and dependents and thse eligible t use yur accunt limited access by cmpleting the Release Frm. Click here fr the mst recent versin f this frm n ur website lcated under the Flexible Benefit Plan Frms sectin. Hwever, yu as the accunt hlder are the nly ne with full access and rights t yur accunt and accunt settings. Our Privacy Statement can be fund here: Ntice f Privacy Practices What benefits are available? 1. Cmpany Spnsred Grup Insurance Premiums Allws yur prtin f the premiums fr yur Cmpany Spnsred Grup Insurance, including Medical, Dental and Visin insurance, t be paid with pre-tax dllars autmatically if yu enrll in the Cmpany Spnsred Insurance Plans. Yur prtin f any premiums will be cntributed t the Plan thrugh pre-tax payrll deductins and paid directly t the insurance cmpany. Yur payrll deductins will be adjusted autmatically fr any changes in premiums charged by the insurance cmpany during the Plan Year. Nte that this is nly fr premiums paid t a grup insurance carrier thrugh yur Emplyer. The Flexible Benefit Plan des nt cver premiums paid fr individual plicies r premiums paid thrugh ther Emplyers (i.e. a spuse s Emplyer r COBRA premiums). If yu wish t pt ut f this pre-tax benefit, yu must ntify yur Emplyer in writing prir t the start f the Plan Year. Yu cannt change yur insurance mid-year and make a crrespnding change t the amunt being deducted frm yur paycheck. There are tw exceptins t this rule: if yu plan these changes prir t cmpleting yur electin frm and yur electin frm reflects these changes, r if yu have a qualified change in status (discussed later). Yur cntributins will cease upn terminatin f emplyment r when yu becme ineligible fr the chsen cverage. 2. Dependent Daycare lg int yur nline accunt t see a shrt vide abut this benefit Cvers dependent daycare expenses which are incurred in rder fr yu and yur spuse (if married) t wrk. The care can be either inside r utside yur hme. These expenses must be fr a dependent child under the age f 13 r fr the care f any tax-qualified dependent wh lives with yu and is physically r mentally incapable f caring fr himself. Electins are lcked in fr the Plan Year unless yu have a qualifying change f status (described later in this Handbk). 4

5 Yur dependent must als live with yu at least 50% f the calendar year and yu may nt claim daycare expenses fr days when yur dependent is nt living with yu. In rder fr yu t participate in the daycare accunt, yur daycare prvider must be ver the age f eighteen, nt yur dependent, and must declare the incme n their tax return. Yur daycare deferrals will nt appear as taxable wages n yur W-2; hwever, the amunt deducted frm yur pay is reprted in Bx 10. Yu will need t file Frm 2441 with yur federal tax return t reprt the prvider s name, address, and tax ID number. Additinally, the amunt frm Bx 10 f yur W-2 must be entered n line 17 f Frm Federal regulatins state that the maximum cntributin yu may make t yur Dependent Daycare Plan is equal t the lesser f: Yur earned incme fr the Plan Year up t $5,000; The actual r deemed earned incme f yur Spuse fr the Plan Year; r $2,500 if yu are married and filing a separate federal incme tax return. This is a family limit, s althugh bth spuses may be eligible fr these types f plans, yu must be careful nt t exceed the federal maximum cntributin amunt. Electins are divided evenly by the number f pay perids in rder t cntribute the full elected amunt by end f the Plan Year. If yu elect the Dependent Daycare FSA, yu are nt entitled t the dependent daycare credit n yur tax return fr expenses paid thrugh yur FSA, but yu may receive a tax credit fr expenses in excess f the amunts paid thrugh yur FSA. Yu may als want t cnsult yur tax prfessinal as each persn s situatin is different and it is imprtant t understand which prgram is better fr yu and prvides the mst savings. Dependent Daycare cannt be reimbursed until the expense has been fully incurred. Fr example, services fr the mnth f January cannt be reimbursed until January 31 st. Yu can nly be reimbursed yur current accunt balance. If yu send in a claim fr $ fr services fr January and yu have $ deducted twice a mnth we will reimburse $ nce the January cntributins are psted and the full mnth has passed. The remaining $83.34 will be reimbursed nce additinal cntributins are psted t yur accunt. Handwritten statements must be n prvider s letterhead r have a prvider stamp cntaining their infrmatin. If yur emplyment terminates mid-year, either vluntarily r invluntarily, yur cverage in this plan will terminate as f that date. Expenses must be submitted within 90 days f the end f the Plan Year. Funds nt claimed by that date will be frfeited back t yur Emplyer. Cntributin amunt limitatins may apply t Highly Cmpensated/Key Emplyees due t Nn-discriminatin rules. Yu will be ntified f these limitatins if yu are affected. The fllwing are eligible dependent daycare related expenses as defined by the Internal Revenue Service: After-schl care r extended day prgrams (supervised activities fr children after the regular schl prgram that are nt educatinal in nature) Befre-schl care r extended day prgrams (supervised activities fr children befre the regular schl prgram that are nt educatinal in nature) Day camp Preschl The fllwing expenses are NOT ELIGIBLE. This is nt meant t be a cmprehensive list but rather a list f ineligible items cmmnly submitted fr reimbursement. Classes r lessns (music, dance, swimming, etc.). Such classes r lessns are primarily educatinal in nature. Kindergarten Overnight camps 5

6 3. Health Expense Reimbursement (Health Flexible Spending Accunt/Health FSA) lg int yur nline accunt t see a shrt vide abut this benefit Cvers ut-f-pcket medical, dental and visin expenses that are nt reimbursed by yur insurance r any ther surce. Fr further infrmatin, see the sectin titled Eligible Expenses fr Yur Health Reimbursement Accunt in this Handbk. Insurance must fully prcess their prtin befre we can issue a reimbursement. If yu and/r yur spuse cntribute r have an Emplyer cntributin int a Health Savings Accunt (HSA), yu are nt eligible t participate in the Health Expense Reimbursement Plan. Yu may be eligible t enrll in a Limited FSA if ne is ffered by yur Emplyer. If available, infrmatin regarding this benefit is included later in this Handbk under the sectin titled Limited FSA. Includes expenses incurred by yu, yur spuse (as defined by federal, nt state, regulatins), and yur dependents up t the age f 26. The prtin claimed must nt be reimbursed by any ther benefit plan r itemized n any tax return. Expenses fr a Dmestic Partner are nt eligible unless they are als yur tax dependent. The maximum yu can cntribute is $2,600. Electins are divided evenly by the number f pay perids in rder t cntribute the full elected amunt by end f the Plan Year. Electins are lcked in fr the Plan Year unless yu have a qualifying change f status (described later in this Handbk). The expense must be incurred during the current Plan Year. This means the service was actually prvided during the Plan Year, nt that yu paid fr r were billed fr the service during the Plan Year. The expense must have been incurred during yur cverage perid, i.e. after yu jined the plan, and befre yu terminate frm the plan. The expense must have been incurred fr the diagnsis, cure, r treatment, f a disease, injury, illness, r diagnsed medical cnditin. General health items are nt eligible. In certain circumstances, a Letter f Medical Necessity frm yur medical prvider may be necessary. Click here fr the mst recent versin f this frm n ur website lcated under the Flexible Benefit Plan Frms sectin. If yur emplyment terminates mid-year, either vluntarily r invluntarily, yur cverage in this plan will terminate as f that date. In sme cases, yu may be able t elect COBRA t cntinue this plan. Yur Emplyer will ntify yu f any COBRA rights yu may have. Yu may be reimbursed up t yur full annual electin amunt at any pint during the Plan Year regardless f the amunt yu have cntributed t date. Handwritten statements must be n prvider s letterhead r have a prvider stamp cntaining their infrmatin. Yu will have 90 days frm the end f the Plan Year t submit a request fr reimbursement f expenses incurred during the Plan Year. Claims submitted after this time perid has ended will be denied as ineligible. Sme plans may elect a Carry Over prvisin, if yur Emplyer elected this prvisin mre details are listed later in this Handbk under the sectin titled, Add On Optins Offered By Yur Emplyer. Cntributin amunt limitatins may apply t Highly Cmpensated/Key Emplyees due t Nn-discriminatin rules. Yu will be ntified f these limitatins if yu are affected. 6

7 Eligible Expenses fr Yur Health Expense Reimbursement Accunt The fllwing list identifies eligible medical, dental, and visin related expenses as defined by the Internal Revenue Service. These expenses are eligible fr reimbursement thrugh yur Health Expense Reimbursement Accunt prvided they are incurred by yu and/r yur dependents during the Plan Year, are nt cvered by yur insurance, and have nt been reimbursed thrugh any ther benefit plan. Yu can als see a mre cmprehensive list n ur website at Click n Participants in the upper right hand crner and under Frms select Benefit Plan Frms. The Medical Eligible Expense List is n the right-hand side f the next screen. Yu will be required t enter the access cde which is: list. Alchlism and drug addictin treatment Ambulance transprtatin Artificial limbs and teeth Birth cntrl/ cntraceptives Braces (wrist, knee, etc.) Cntact lenses and slutin (See Stckpiling) Deductibles (Insurance) Dental Implants & dental treatments (excluding csmetic prcedures) Eye examinatins Eyeglasses (crrective lenses) Fees t dctrs and hspitals including: Anesthesilgist Optmetrist Chirpractr Ostepath, licensed Clinic Practical Nurse Dermatlgist (Nte 1) Psychiatrist Gyneclgist Psychlgist Midwife Neurlgist Hearing aids and batteries (including upkeep and maintenance) Infertility treatment Insulin and related supplies Labratry fees Laser/Lasik eye surgery Mentally challenged (special tutring/care f) Nursing care Office visit c-payments (fr medical appintments) Orthdntia (Nte 2) Oxygen equipment Physical therapy Pregnancy tests Prescriptin drugs and medicines Radial Kerattmy / Orthkeratlgy Sterilizatin Supprt r crrective devices (i.e. rthpedic shes) Surgery (excluding csmetic prcedures) Transprtatin expenses fr medical care (mileage, parking, tlls, bus, taxi) Wheelchair / crutches X-rays The Fllwing Expenses are cnsidered DUAL PURPOSE: These items are nly cvered with a 7 diagnsis cde frm a medical prfessinal. This is nt meant t be a cmprehensive list but rather a list f items cmmnly submitted fr reimbursement. Capital expenses primarily fr medical purpses (t the extent the value f yur hme is nt increased) Massage Over-the-cunter drugs and medicatins including vitamins and supplements (Nte 3) Psychtherapy Smking cessatin prgrams and related drugs Weight lss prgrams The Fllwing Expenses Are NOT ELIGIBLE: This is nt meant t be a cmprehensive list but rather a list f ineligible items cmmnly submitted fr reimbursement. COBRA payments Csmetics / tiletries Csmetic surgery / prcedures Dental Supplies (including tthbrushes) Electrlysis / hair lss treatments / Rgaine Insurance premiums Multi-vitamins Teeth bleaching (csmetic) Tinted clips fr prescriptin eyewear Nte 1: Services cannt be csmetic and a diagnsis is required. Nte 2: Please cntact Pensin Dynamics fr infrmatin n hw t submit Orthdntia claims. Nte 3: Due t Health Care Refrm a prescriptin is required fr all ver-the-cunter (OTC) drugs and medicatins. They must be purchased fr the treatment f a medical cnditin, illness r injury. A diagnsis is required. Stckpiling is NOT permitted. N mre than tw frmulatins f the same OTC will be reimbursed in any given mnth.

8 Hw d I submit a request fr reimbursement? Claims can be submitted electrnically thrugh ur website at Instructins fr nline claims submissin are here: Online Claim Submissin Additinally, yu are able t submit claims via ur mbile app. The mbile app can be fund by searching fr Pensin Dynamics Wealth Care in the Apple App Stre r Ggle Play. Requests fr reimbursement shuld be sent t Pensin Dynamics. Click here fr the Flexible Benefit Reimbursement Frm n ur website lcated under the Flexible Benefit Plan Frms sectin. All Health Care substantiatin must include: Name f patient (yu, yur spuse r tax dependent) incurring the expense The date services were prvided r the date the item was purchased Service Prvider r Merchant Name Descriptin f Service/Purchase Amunt f Service/Purchase If insurance is paying any prtin it must be finalized with insurance first and the statement must clearly shw the insurance cmpany payment/write ff amunt. In this case, an Explanatin f Benefits (EOB) is recmmended and in sme cases the EOB is required. All Dependent Daycare substantiatin must include the fllwing: Dates f Service (dates care prvided, nt when billed/paid fr) Descriptin f Service Dependent's Name Care Prvider s Name Prvider s Tax ID r SSN Amunt f Claim Fr Dependent Daycare claims, if yur prvider des nt give receipts Pensin Dynamics can accept the prvider's signature n the cmpleted claim frm as prf f yur expense. Canceled checks, credit card receipts, and statements including "Previus Balance", "Balance Frward, r "Paid n Accunt" are NOT acceptable as they d nt cntain all f the required infrmatin. Handwritten statements must be n prvider s letterhead r have a prvider stamp cntaining their infrmatin. Reimbursement will be made by direct depsit int yur bank accunt when yu submit a cmpleted Direct Depsit Frm. Click here fr the Direct Depsit Frm n ur website lcated under the Flexible Benefit Plan Frms sectin. Yu can als sign up fr direct depsit nline at the participant prtal. Direct depsit allws Pensin Dynamics t send yur reimbursements t yu electrnically which will reduce the amunt f time that it takes fr yu t receive yur reimbursement. Payments are issued daily and sent t the bank the same day in mst cases. The bank prcesses these depsits int yur bank accunt within 1-2 business days. Can I make a mid-year change t my electins? Yu may change yur electins during the plan year nly if yu have a qualifying change in family status. Yu may stp participatin in the plan nly if yu have a qualifying change in family status r if yu take a leave f absence. Upn the ccurrence f ne f these qualifying events, yu will need t cmplete the Flexible Benefits Enrllment/Revisin Frm and submit it t the Human Resurces Department within 30 days f that event. All requests fr electin changes are subject t apprval by the Plan Administratr. The Flexible Benefits Enrllment/Revisin Frm is included in this Handbk. 1. Qualifying Change in Family Status - If yu underg a qualified family status change, yu may make changes t yur electins accrdingly. Fr example, if yu gain a dependent yur Health Care Expenses might increase. In this example yu culd increase, but nt decrease yur electin. The fllwing is a list f qualifying changes in family status: 8

9 Legal Marital Status Gain r lss f a dependent (birth, adptin, death, exceed age limit, etc.) Significant change in participant s emplyment status r wrk schedule Terminatin r significant change in participant's spuse s emplyment status Significant change in participant's spuse's cmpany spnsred benefits/eligibility Significant change in cst fr daycare expenses (fr changing daycare electins nly) 2. Unpaid Leave Of Absence r FMLA Leave - If yu g n an unpaid leave f absence yu will nt have spending accunt deductins taken n the missed pay dates. Yu have the fllwing ptins regarding yur leave: In rder t cntinue yur eligibility thrugh yur leave yu will need t make up these missed deductin amunts. Yu may frnt lad yur accunt (cntribute in advance all missed deductins) in anticipatin f yur leave. If yu frnt lad yur accunt yu will have cntinuus, uninterrupted cverage during yur leave, r If yu expect t return t wrk well in advance f the clse f the Plan Year, yu can make up yur missed cntributins after yu return t wrk. Hwever, reimbursements will be suspended during yur leave until all missed cntributins have been made up. Once all required cntributins have been made, yur eligibility will be reinstated retractively and claims incurred during yur leave are eligible fr reimbursement, r If yu are nt returning by the end f the year and yu d nt frnt lad yur accunt, yu can pay the missed deductins n an after-tax basis by sending mnthly payments t yur Emplyer, r Yu can terminate yur participatin in the plan n the effective date f yur leave f absence. ADD ON OPTIONS OFFERED BY YOUR EMPLOYER Debit Card Carry Over Yu may request a debit card t help pay fr expenses in the abve mentined plans. T request a card please benefits@pensindynamics.cm. If yu wuld like a card fr a dependent as well as yurself please prvide the dependents name, date f birth and relatinship t yu in yur request. Once yu receive the card, yu may use it t pay fr yur qualified expenses; hwever, unless the expenses are fr c-payments under the Cmpany Spnsred Grup Insurance Plan, yu will still need t submit substantiatin f yur expenses. An will be sent t yu fllwing each debit card transactin stating if substantiatin is required. It is imprtant t keep all receipts in case they are needed. If substantiatin is nt received within 30 days f the transactin, yur debit card will be suspended and n further transactins will be prcessed until substantiatin is received. If incmplete dcumentatin is submitted, yur card will be suspended and n further transactins will be prcessed until substantiatin is received. If yu are nt able t substantiate yur claim, yu can either (1) submit a claim fr eligible expenses nt purchased with the debit card in rder t ffset the unsubstantiated transactin, r (2) yu may repay the plan. Please cntact Pensin Dynamics fr infrmatin n these situatins. Als it is imprtant t review the Cardhlder s Guide and Plicy fr Disputed Pint-f-sale Transactins which is lcated here: Cardhlder Guide t Claim Plicy The IRS permits carryver f up t $500 f a Health Care Reimbursement Accunt balance int future Plan Years. They require any unused funds ver $500 remaining in yur accunt at the end f the Plan Year be turned ver t the Emplyer, nt the emplyee wh frfeited them. The IRS has very strict guidelines n hw these funds can be used by the Emplyer. This Carry Over prvisin is available fr all active participants in the Health FSA, including active emplyees and COBRA participants enrlled in the Health FSA accunts. The Carry Over prvisin des nt apply t the Dependent Daycare Reimbursement prtin f this plan. 9

10 Online Enrllment Instructins Online enrllment is available fr yur plans during Open Enrllment. Yur HR department will send yu details n when this Open Enrllment Perid is available. In rder t enrll nline yu will need t cmplete the fllwing steps: Lg int yur accunt n ur nline participant prtal at benefits.pensindynamics.cm. If yu have nt already registered fr this site, please see the website registratin instructins n the next page. Click n the Enrllment Tab/ Open Enrllment Find the plan that yu wuld like t enrll in and click Enrll Nw. Verify and edit yur demgraphic infrmatin. Be sure all fields marked with an asterisk (*) are cmpleted. If applicable, add any dependents by clicking the Add Dependent buttn and prviding the required demgraphic infrmatin. When all participant and dependent demgraphic infrmatin has been entered, click Next. Prvide yur cverage/electin chices. Depending upn the plan yu are electing, yu may be asked t chse an annual electin r a per-pay-perid electin. Once yur selectins have been made, read and check the certificatin acknwledgement checkbx and click Next. A summary page lists all f yur entered demgraphic infrmatin and cverage selectins. Verify that all infrmatin is crrect and use the edit buttns t change anything as needed. When cmpleted, click submit applicatin. A cnfirmatin message will appear indicating the enrllment prcess is cmplete. Clicking dne takes yu back t the main pen enrllment page. The enrllment summary sectin f the pen enrllment page nw displays the plan with a cmpleted status. Electins and dependent infrmatin that yu entered during the enrllment prcess appear as well. Yu can return t this page t make changes r waive cverage up until the end f pen enrllment. Yu are als able t Waive cverage by clicking n Waive Nw. Check the bx acknwledging that yu are waiving the ffered cverage and click submit. The enrllment Summary nw reflects that yu have waived this plan by shwing a status f waived. Yu can cancel yur waived status and enrll in the plan at any time up until the end f the plan s pen enrllment perid. If yu have any questins d nt hesitate t call us at (925) r send an t benefits@pensindynamics.cm. 10

11 Web Site Registratin Instructins and Online Claim Entry Submissin Please fllw the instructins listed belw t access the Pensin Dynamics Wealth Care Prtal: Navigate t the fllwing URL: pensindynamics.cm/lgin Click the BENEFITS LOGIN buttn n the bttm right f the screen Click the REGISTER buttn atp the right crner f the hme screen Cmplete the registratin frm: Chse a username (8-100 characters) and passwrd (8-16 characters). Enter the required demgraphic infrmatin. Yur emplyee ID is yur Scial Security Number (SSN) with n spaces and n dashes. Yur emplyer ID is PDCFB231. Befre clicking register, be sure t view and accept the terms f use. After successfully cmpleting the registratin frm, click register (may take several secnds). Next yu will set up yur secure authenticatin, which helps ensure yur accunt is secure and private. T start, click the BEGIN SETUP NOW buttn. Select fur security questins and prvide yur secret answers. Verify yur address. Once cmplete, click CONTINUE SETUP. Submit setup infrmatin. Yu will be asked t verify all f the infrmatin yu have entered. After yu ve reviewed and cnfirmed the infrmatin, please click SUBMIT SETUP INFORMATION. A cnfirmatin page will display shwing the registratin prcess has been cmpleted. At this pint, yu can either 1) sign ff, r 2) prceed t yur accunt. After registering, fr all subsequent lgins yu can click the LOGIN link in the upper right crner f the hme page. Yu will be prmpted t enter yur username, tw f yur fur security questins, and finally yur passwrd. Online Claim Entry: At the navigatin bar at the tp f the page, select Submit Claims and click the ADD NEW buttn. Cmplete the claim frm. Items with an asterisk are required. Add a receipt file if yu have ne. Select OK when finished. Newly-entered claims appear in the New Claims bx. Click the EDIT buttn t edit anything yu have entered n a claim. Additinal claims can be added by clicking the ADD NEW buttn again. NOTE: Once yu submit yur claim, yu are n lnger able t edit it. When cmplete, acknwledge the certificatin text by checking the checkbx and click the SUBMIT buttn. If it is preferable t fax yur receipts, click VIEW RECEIPT SUBMITTAL FORM fr a printable cver page yu can submit while faxing. Faxing in yur receipt withut this cver page may cause yur reimbursement t be delayed, as the cver page cntains specific infrmatin that speeds up the prcess f linking yur receipt with yur claim in ur system. Our new fax number is (844) If yu have any questins, please call (925) r us at benefits@pensindynamics.cm. 11