2014 Dental and Vision Plan Flexible Spending Account

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1 2014 Dental and Vision Plan Flexible Spending Account

2 Dental Benefits Benefit Calendar Year Maximum Benefit for Combined Types A, B, & C expenses Lifetime Maximum Benefit for Type D expenses Type A: Diagnostic & Preventive Services Type B: Basic Services Type C: Major Services Type D: Orthodontics Current Coverage $1, per covered person $1, per covered dependent child to Age 19 or 25 if a full time student 80% of R & C Charges* 80% of R & C Charges* 50% of R & C Charges* 50% of R & C Charges* *R & C = Reasonable and Customary

3 Dependent Age New Max Age Coverage for unmarried dependent child(ren) ages will be available through calendar year of attaining age Dependent child(ren) over 19 must be a full time student Orthodontia coverage will be available to age 19 as it currently is

4 Vision Benefits Benefits for eye exam, lenses (including contact lenses) and frames $ per Calendar Year per Covered Person Coverage for unmarried dependent child(ren) ages will be available through calendar year of attaining age Dependent child(ren) over 19 must be a full time student

5 Flexible Spending Account (FSA) For healthcare expenses if you do not have a Health Savings Account (HSA) Set aside up to $2,500 tax free for eligible medical, Rx dental and vision out of pocket expenses Results in 25-30% savings Must re-establish the account each Calendar Year Expenses must be incurred between Jan 1 and Dec 31 FSA available even if you do not have your medical plan through Kellogg Community College

6 2014 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. No income requirement for the child of an employee if under age 27 during the entire taxable year.

7 How it works Evaluate family s healthcare needs. Estimate out-of-pocket costs after insurance pays. Consider deductible amounts, copayments, coinsurance and out-of-pocket maximums. Estimate conservatively; IRS rule use or forfeit. Divide amount by the # of pays = amount deducted tax free per pay and deposited into your FSA account. Mid-year election changes? Not without a qualifying event!

8 How it works Submit early! Complete a Request for Reimbursement form. Attach an Explanation of Benefits from your benefit payor. Submit to Meritain Health. Watch mail for requests for substantiation. You have up to 60 days after the end of the Calendar Year to submit your Requests for Reimbursement. Low balance? Advance funding is available if expenses are incurred early in the Calendar Year. Remember: What goes in to the account must come out of the account each year; it is a spending account.

9 Limited Flexible Spending Account If you have a Health Savings Account, the Flexible Spending Account is limited or restricted to: Dental expenses Vision expenses (Medical and prescriptions only AFTER the high deductible HAS BEEN MET.) Great strategy for handling predictable dental and vision out-of-pocket expenses. Use tax free FSA dollars save your HSA dollars! It works the same way but what goes into the account must come out each calendar year. 9

10 FSA for Dependent Care IRS allows $5,000 $5,000 tax free for childcare to age 13 or elder care for IRS dependents. Determine the amount needed for the year. Divide by the # of pays = the amount deducted from your pay tax free and deposit into your Account. To obtain funds, complete a Request for Reimbursement form and submit with receipt to Meritain Health. No advance funding; funds must be in the account. What goes into the account must come out of the account each calendar year. 10

11 IMPORTANT DEADLINES Plan Incur Expense Submit Claim Health Care 12/31/2014 2/28/2015 Dependent Care 12/31/2014 2/28/

12 Direct Deposit Fast and easy! For fast and easy reimbursement on expenses, sign up for direct deposit. Use the direct deposit form to sign up. Return the form via the fax number or mailing address on the form. Allow 10 days for Meritain to setup your direct deposit account. Explanation of Benefits (EOB) will still arrive in the mail. 12

13 Questions? Web: New user: Create a new user account with Group number Returning user: Log in or Select I Forgot for a login ID and/or password Call: Press 2 for the automated system Press 3 for a Customer Service Representative 13