Custom Design Benefits, Inc Cheviot Cincinnati, Ohio

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1 Custom Design Benefits, Inc Cheviot Cincinnati, Ohio

2 Southern State Community College Flexible Spending Account Plan (FSA) (Medical Reimbursement Account) PLAN BENEFIT YEAR January 1, 2013 through December 31, 2013

3 Southern State Community College Flexible Spending Account (Medical Reimbursement Account) Eligible Medical Expense Deductible, co-pays, co-insurance Lasik Eye Surgery Eyeglasses / contact lenses Dental/Vision (member portion) Orthodontia Hearing Aids Rental of medical equipment Lab fees, x-rays Over-the-counter items with a prescription

4 Dependent Care Account You may set aside up to $5,000 per plan year into this account. ($2,500 for married Plan members who file separate tax returns.) Eligible Dependent Care Expenses Daycare expenses for IRS dependent children Daycare expenses for IRS dependent adults Preschool (not including Kindergarten tuition) Latch Key Programs - up to age 13 Summer Day Camp - up to age 13

5 IRS Guidelines & Terms of the FSA Plan Use care when estimating your annual election amounts! Mid-year election change is only permissible if a qualified Work/Life Status change occurs, and FSA dollars do NOT carry forward year to year. Active employees must submit for reimbursement within 60 days of 12/31/13.

6 Take Care Debit Card The easiest way to access the funds in your FSA account is to use your take care VISA debit card. When you pay with the card, your purchase amount is deducted from the appropriate balance in your Flexible Spending Account. Certain payments will require further verification, so please hold on to your itemized bills and receipts. Custom Design Benefits will request documentation only when it is needed. NEW FOR 2013 Cards now have three-year expiration dates

7 Take Care Debit Card Purchases that do not require receipts

8 Take Care Debit Card Purchases that may require receipts

9 Debit Card Purchases that always require receipts or paper claims

10 How Do I Get My Money If I Didn t Use My Debit Card? Complete a CLAIM FORM only if your debit card was not used. Medical Complete required information on claim form and attach an EXPLANATION OF BENEFITS (EOB) or STATEMENT/RECEIPT detailing expenses not covered by carrier. Dependent Care Complete required information on claim form and attach RECEIPT for expenses from Dependent Care provider. All reimbursements are mailed to the employee at their home address Or issued by direct deposit if banking information is on hand Mail completed form and receipts to: Fax to OR to FlexClaims@CustomDesignBenefits.Com Custom Design Benefits, Inc Cheviot Road Cincinnati, OH 45247

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12 CUSTOM DESIGN BENEFIT S ACCOUNT SERVICES Dedicated Claims Administrator Daily Claims Adjudication Allows you to keep the most updated information on your account Check Issuing (Daily) or Debit Card Debit Cards allow you to pay certain out-of-pocket expenses on the front end but you must retain documentation for verification of purchase. We may request some receipts. 24/7 Account Balance Information Internet Services Interactive Voice Response System

13 How Do I Find Out About My Flexible Spending Account & Health Reimbursement Arrangement Balances throughout the Year? Custom Design Hotline: Local/National Custom Design Website: Enter your SSN# and password (You will need to set your password on the first visit only.) Reimbursement Check The Y-T-D balance summary is provided on each reimbursement check to help manage your account

14 INTERNET SERVICE FLEXIBLE SPENDING ACCOUNTS You can view: annual election amount for current & prior plan year contributions made to FSA Account claim status and reimbursement remaining balance last payment date & amount You can also access claim forms online at: CustomDesignBenefits.Com

15 Access Custom Design Benefits Website The screen will look exactly as the outline of the next few slides. Click on the Member s tab. Once you see the options from the drop down box you need to access Section 125-Flex The first time you access your personal information, you will need to establish a password

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