MGM Flex Guide
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- Polly Golden
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1 MGM Flex Guide
2 Welcome to MGM Benefits Group, your Third Party Flexible Benefits Plan Administrator! With over 30 years experience in employee benefits administration, MGM Benefits Group has partnered with your employer to bring you a state of the arts Flexible Benefits Plan. Enjoy the features of your own Flex Website, with 24 hour access, where you can: Create your own password Review your account balance, recent transactions and payroll contributions posted to your account File your FSA claims online Receive updates to process your claims Get confirmations for your direct deposits View status of reimbursement checks Download claim forms and other plan forms and information We encourage you to review the information in this guide to make informed decisions about your flex account that will benefit you and your family. Benefit Counselors are available to assist you from 8am to 5:30pm (CST), Monday through Thursday and 8am to 2:00pm (CST) on Friday. Mail Claims: MGM Benefits Group 2121 N. Glenville Drive Richardson, Texas Contact Phone: (800) Fax Claims: (800) Website: Questions to: flexsupport@mgmbenefits.com 2
3 What s Inside How the Plan Works... 4 Managing Your Flexible Spending Account... 5 Health Flexible Spending Account... 6 Special Health Care Expenses... 7 Eligible Health Care Expenses... 8 Over the Counter (OTC)... 9 Dependent Care Flexible Spending Account...11 FSA Worksheet...13 MGM Website Homepage...14 Participant Website...15 Your Personal Account...16 Participant Website Homepage...17 Participant Website Profile...18 Election Summary...19 Account Summary...20 Claim Filing Options...21 MGM Flex Card...22 Online Claim Filing...23 Manual Claims...25 How to Substantiate Claims...26 Debit Card Auto-Substantiation
4 How the Plan Works An IRS Section 125 Plan provides participants an opportunity to receive certain benefits on a pre-tax basis. Under your Employers Plan, you may pay the premiums pre-tax for your medical, dental, cancer and vision insurances. Flexible spending accounts are also offered for your health care and dependent care needs for you and your family. Flexible Spending Accounts A Flexible Spending Account (FSA) is a special account for healthcare and dependent care expenses. When you enroll in an FSA, you decide how much to contribute to each account for the entire Plan Year. This annual contribution is then deducted in equal amounts from your paycheck, before Federal & State income taxes and FICA taxes are deducted. These pre-taxed funds are automatically deposited in your account through payroll deduction. Unless you have a qualifying event under Section 125 regulations, your election amount will not change during the Plan year. 4
5 Managing Your Flexible Spending Accounts There are two kinds of Flexible Spending Accounts: Health FSA Dependent Care FSA You may choose to participate in both plans, depending on the options provided by your employer. Funds in these accounts cannot be co-mingled and the expenses must be incurred during your employer s plan year. Expenses for your flex accounts must be incurred during the plan year, and any remaining funds that are not used will be subject to the use it or lose it rules regulated by the Internal Revenue Service. Therefore, a decision as to how much you will contribute to your FSA accounts should be made carefully. Based on your Employer s flexible benefits plan year, you have a specified date or run-off period following the end of the plan year to submit your claims for reimbursement. If you do not exhaust your account balance, during the run off period or at the end of any applicable grace period, those funds will be forfeited after this claim period ends. The IRS allows employers to provide employees a grace period of up to two and a half months from the end of the FSA plan year to spend unused money in their FSAs. Eligible expenses incurred during this grace period are first applied to the remaining FSA balance in the prior plan year. The grace period only applies to the health FSA. Ask your employer if your plan has a grace period. Check with the Plan Administrator to verify the last date that you may file claims to be reimbursed for your eligible FSA expenses. You can also view the final dates for incurring expenses and claims submission on your personal website account. 5
6 Health Flexible Spending Account A Health Care Flexible Spending Account (FSA) is designed to reimburse your out-of-pocket health care expenses incurred by you or your eligible dependents that are not reimbursable by your medical, dental and vision insurance plans. Eligible Health Expenses These expenses may be incurred by you or your eligible dependents. Expenses include deductibles, coinsurance payments, office co-pays, orthodontics, glasses and contacts. An eligible expense item must not be used for general health or cosmetic purposes. In some instances, you will be required to submit a letter of medical necessity from your health care provider to demonstrate a medical need. Once enrolled in a health FSA, the entire annual election is available to you on the first day of the plan year. You must spend the funds by the end of the plan year or they will be forfeited from your account. 6
7 Special Health Care Expenses IRS does not allow pre-payment of certain medical treatment programs that may span over multiple plan years. These include orthodontic and prenatal expenses. Reimbursement of the entire expense generally violates the IRS requirement that expenses must be incurred during the coverage period and cannot be paid in advance. Orthodontic Expenses Orthodontic expenses can be reimbursed in a health care FSA. You should carefully plan when deciding on your annual election if it includes orthodontic expenses. Special planning should be considered if you are planning to take advantage of an up-front discount payment. Please remember, services must be performed and incurred within the current plan year. Reimbursement of a lump sum payment to a dentist may not be considered as an eligible expense. Reimbursement for services that overlap plan years must be claimed in the plan year in which services were incurred and rendered. You will need to provide a copy of your contract with your dental provider, showing the initial deposit and monthly payments. This expense may be setup as a recurring expense throughout your plan year. Prenatal Expenses Some Maternity related expenses under a health FSA cannot be paid in advance, but are reimbursed as they are incurred. Eligible charges may be reimbursed each time you are seen by your physician for prenatal care but prepayment for delivery charges are not allowed under IRS guidelines. Expenses related directly to the delivery may be reimbursed following the delivery, if the birth occurs within the same plan year. 7
8 Eligible Health Care Expenses Partial List of Medically Necessary Services & Items (Some items may require the submission of a Doctor s certification stating the nature of medical condition and required treatment) Dental Services Crowns & Bridges Dentures Exams/Teeth cleaning Extractions Fillings Implants Oral surgery Orthodontia Services Insurance Co-pays Deductibles Medications Contraceptives Drugs (prescriptions) Insulin treatment Laboratory Fees & Tests Blood tests & transfusions Diagnostic tests/health screenings Lab fees X-rays Medical Equipment & Supplies Ambulance service Breast pumps (primarily for medical care) Crutches Guide dog Hearing aids and batteries Oxygen equipment Prosthesis Wheelchair Medical Services & Providers Acupuncture Anesthetist Chiropractic care Hospital services Immunizations & Vaccinations Injections Laboratory fees Medical records fees Nursing Services Physical therapy Operating room fees Optometrist/Ophthalmologist fees Organ transplant Specialty physicians & Surgeons Sterilization Surgery Transportation to medical care Transplants Obstetric Services OB/GYN Exams & Treatment OB/GYN Prepaid Maternity fees (reimbursable after birth) Vision Services Laser eye surgery Eye exams Eyeglasses & Sunglasses (corrective) Contact lenses (corrective) & supplies Non-Eligible Items Cosmetic Surgery/Procedures Dietary Supplements (vitamins) Electrolysis Exercise or health club memberships Finance charges & convenience fees Insurance premiums Massage therapy* Personal care items Teeth whitening/bleaching Weight reduction (general health, fees, programs, food) Vision insurance (contacts & eyeglasses) *Massage therapy must be required for the treatment of a specific medical condition, and is not an eligible expense for stress relief or to improve general health and well being. 8
9 Over The Counter (OTC) Items The recently enacted Patient Protection and Affordable Care Act of 2010 changes the rules for the purchase of over-the-counter (OTC) products using Flexible Spending Accounts (FSA). Effective for tax years January 1, 2011, a doctor's prescription is required before you can be reimbursed for over-the-counter (OTC) drugs and medicines (e.g. Advil, Ibuprofen, and cough syrup). Drugs and medicines must be primarily for medical care (and not for personal, general health or cosmetic purposes) and issued by a legally authorized medical professional. The prescription must be submitted with the expense reimbursement request. Insulin is the only medicine that doesn t require a prescription. Supplies for medical care (e.g. contact lens solutions, bandages for wounds, thermometers) will continue to be eligible for reimbursement. As an alternative to this ruling, prior to the purchase of OTC s, a doctor s prescription for OTC drugs and medicines may also be submitted to a pharmacist and the drug dispensed in accordance with applicable law. A prescription number (Rx number) assigned by the pharmacy must include the name of the purchaser or the name of the individual designated for the prescription and the date and the amount of the purchase. If your employer offers the MGM debit card, you may purchase a prescribed OTC with an assigned Rx number that contains this information. There are some medical items or conditions that may not be eligible for reimbursement without a letter of medical necessity or prescription from a medical professional, which indicates a specific medical condition. We recommend you retain copies of all OTC documentation for your records. Documentation for reimbursement must state the location of purchase, date, amount and item name. Purchases can be claimed within reasonable quantities, but items should not be excessively stock piled. 9
10 OTC Expenses Eligible Over-the-Counter Expenses Beginning January 1, 2011, an IRS ruling specifies a prescription is required for OTC medicines and drugs. The following is a partial list of eligible OTC s allowed without a prescription: Band-aids Crutches Heating pads Birth Control Denture adhesives Incontinence supplies Blood pressure monitors & kits Diagnostic tests & monitors Insulin & Diabetic supplies Braces, supports & wraps Elastic bandages & wraps Ostomy products Catheters Ear plugs Reading glasses Cold/hot packs First aid kits Smoking cessation products Contact lens solution Gauze pads Wheelchairs, walkers, canes Over-the-Counter Expenses that Require a Prescription Beginning January 1, 2011, OTC drugs and medicine, with the exception of insulin, must have a prescription from your physician to be eligible. The MGM debit card accepts prescribed OTC drugs and medicines that are dispensed through a pharmacist and dispensed with a prescription number. Mail order vendors that dispense drugs and medicine are also allowable. The following is a partial listing of drugs and medicines that are not eligible unless accompanied by a physician prescription or dispensed through a pharmacist: Acne medicine Baby rash ointments/creams Motion sickness Acid controllers Cold sore remedies Nicotine gum or patches Allergy & Sinus medications Cough, cold & flu medications Pain relievers Antacids Digestive/Stomach aids Respiratory treatments Antibiotics Feminine Anti-Fungal/Anti-Itch Sleep aids & Sedatives Anti-Diarrheals First aid cream Sun block & Sun screen Anti-Itch & Insect bite Hemorrhoidal creams Throat lozenges Anti-Parasitic treatments Laxatives Wart remover treatments Non-Eligible OTC Items OTC Drugs and medicine (with the exception of insulin) are not eligible for reimbursement without a physician's prescription after 12/31/2010. Medical supplies will still be eligible for the Health FSA after 12/31/2010. Items or services that are obtained primarily for personal, cosmetic, or general health purposes and not primarily for medical care do not qualify as eligible expenses. Examples include: diapers, food items, hand sanitizers, humidifiers, nonprescription eyewear, personal hygiene/care items, weight loss drugs, vitamins and items used to promote health and well being. 10
11 Dependent Care FSA Eligible DCAP Expenses The Dependent Care Assistance account allows you to pay for employment related expenses that enable you and your spouse to be gainfully employed, seek employment, and/or be a fulltime student. In general, expenses must be for the care of a qualifying individual. Reimbursement may also include eligible expenses for children or elder dependents that rely on you for their care. Some examples of eligible expenses include: care in and outside the home child-care/dependent care centers before and after school care nursery school and preschool expenses preschool tuition Day care camps and facilities (only for care and not primarily for educational purposes). Adult day care expenses Registration fees to a day care facility (must be for actual care) Deposits to hold a space at day care center (cannot be reimbursed until after dependent care services commence) Expenses for services provided outside the employee s home by dependent care centers must comply with state and local laws. Your care provider must report day care income on their taxes to be considered as eligible. Dependent Care FSA must be for children under 13 years of age, unless they meet the qualifications of physically or mentally incapable of self-care. DCAP Reimbursements The total amount you choose to contribute should be based on your expected child and/or dependent care expenses during the plan year. The Federal limit for the dependent care FSA is $5,000 per year, per household. Married participants can each elect an FSA, but their total combined elections cannot exceed $5,
12 IRS requires that the amount reimbursed to a participant in a DCAP must first be on deposit in their account. When a claim is filed we first verify that there are adequate funds in the account to pay the entire claim. When sufficient funds are not available, participants are issued the maximum amount available on deposit in their account. The remainder of the reimbursement request is paid when additional funds are received through payroll deposits. There are two options to substantiate reimbursement for your day care claims: A MGM Dependent Care claim form signed by your day care provider as authorization that the dates, description of services and charges are valid, or A MGM Dependent Care claim form with a receipt from your day care provider When submitting a receipt for day care services, the itemized receipt must contain the following information to be valid: Name of individual receiving services Name of service provider Description of service Amount of expense Dates of service (not the same as the paid date) Ineligible Expenses The following items are examples of expenses that are generally considered as ineligible for reimbursement in a Dependent Care FSA: Educational expenses, except where an eligible child attends preschool or nursery school Field trips, clothing Late payment or finance charges Payments for lessons Tuition expenses Overnight camps Kindergarten expenses Payments forfeited for applications, registration or deposits because of change in day care provider 12
13 FSA Worksheet Estimated Eligible Expenses The estimated worksheet will help you decide the amount you will spend for your medical and/or dental expenses during your employer s plan year. In planning, also consider expenses for your eligible dependents. You may claim their expenses even if they are not carried on your employer s medical insurance plan. Medical Expenses Annual Estimat Dependent Care Deductibles, co-pays, $ After School $ Physician visits/routine $ Summer Care $ Prescription drugs $ Adult Day Care $ Diabetic supplies $ Other $ Chiropractic treatments $ Dependent Care $ **Eligible over-the-counter $ Other: $ Dental Expenses Routine Cleaning and $ Filings & Crowns $ Root canals $ Crowns/Bridges/Dentures $ Oral surgery $ Orthodontia $ Other: $ Vision Care Exams $ Glasses (eyeglasses & $ Contact Lenses & Cleaning $ Corrective Eye Surgery $ Other: $ Total Unreimbursed $ Annual Estimate ** Effective January 1, 2011, OTC Drugs and medicine (with the exception of insulin) are not eligible for reimbursement without a physician's prescription. Medical supplies will still be eligible for the Health FSA as of January 1,
14 MGM Homepage Logon to to sign into your personal website account. Participant Login offers help for the username and password Follow these easy steps to create your own Participant Website: 1) Open your web browser (e.g. MS Explorer) and go to the following website: 2) Under participants, click on Log in Help for assistance on your username and password. This information was also sent to you via your enrollment confirmation. 3) Username: The first initial, last name & last four digits in your social security number (your username will not change) 4) Password: Your last name & last four digits in your social security number. This formula is used to create your initial password, but you will be prompted to create a new password along with a security question and answer. 14
15 Participant Website Website Access The MGM Flex system offers participants the ability to manage their own account information. Participants can log in to their personal accounts to: Create your own password File your FSA claims online Review your reimbursement claims by provider name, date and amount Create your own direct deposit accounts Obtain information on how to use the MGM Flex Card Dependent process to add and request debit cards for eligible dependents Obtain FSA claim forms Refer to a listing of certified merchants for prescription debit card purchases Access to documents with information on how to use your Flex Plan And much more! Once enrolled in the administration system, you will receive an enrollment confirmation with instructions for accessing the website to initiate your account setup and review your account elections. 15
16 Your Personal Account You can view up-to-date account information at any time you choose. Account: Check your FSA account balances and the payment history of your account. You can also file claims, see claim documentation that is needed, and view your election summary and the plan description for the FSA accounts. Profile: You can review your personal and dependent Information on file in the system. (To add your dependents, click on the Add Dependents option available on the website home page). Notifications: To see a detail of the claims that have been paid you can click View Detail for more information about any claim. Forms: You can download the Health FSA or Dependent Care FSA claim forms at any time. Log on and click on the Forms tab, and select the form to download. 16
17 Participant Website Homepage Action Required: Check for Receipt notices (for valid documentation)to verify transactions for claims approval. Account Information: FSA account type with plan year dates Available Balance Final Service Date: last day in plan year that claims may be incurred Final Filing Date: last day to be reimbursed for claims incurred during plan year Actions: File Claims or view claims history for current plan year 17
18 Participant Website Profile Demographics for your personal information address Listing of eligible dependents Direct Deposit Information 18
19 Election Summary View the Plan Elected (Health Care FSA and/or Dependent Care FSA) Annual election and payroll contribution amounts Plan dates for expenses 19
20 Account Summary View your: Annual election amount Claims submitted Available balance 20
21 Claim Filing Options How to File Claims You may file your claims by one of the following methods: 1. If your employer offers the MGM Flex Visa Card: use your Card at the point of purchase towards qualified expenses. 2. Online Claim Filing: file your claims online via our participant website. 3. Paper Claim Filing: file claims using the Health Care and/or Dependent Care Reimbursement Claim Forms available on the website under the Forms tab. Health Care Flexible Spending Claims: Your account balance is available for use on the first day of the plan year Funds remaining in your account that have not been spent by the end of the Plan Year will be subject to the use it or lose it rules for IRS regulations Based on your Employer s Plan rules, you will have a specified time period following the last day of your plan year to request reimbursement for expenses incurred, but not claimed, during the plan year. The final dates for filing are posted on your personal website Some health care items may be eligible only if you are diagnosed by a medical professional for a specified medical condition. For these expenses, you will be asked to provide a copy of diagnosis and treatment from your physician. Dependent Care (DCAP) Flexible Spending Claims: The MGM Flex Card does not accept charges for dependent care related expenses Claims may be filed by Paper or Manual claims or online through the Participant website Funds must be available in your dependent care accounts prior to reimbursement IRS regulations do not allow pre-funding of DCAP accounts. Always be sure to keep your receipts no matter which option you may choose for claim reimbursement. 21
22 MGM Flex Card The MGM Flex Card makes using your Health FSA quick and easy. Just swipe it to pay for your eligible expenses and the funds are automatically deducted from your account. If your Employer offers the MGM Flex Card, it is an automatic way to pay for qualified health care expenses. It is not a credit card, but can be used to pay for your eligible health flexible spending account (FSA) purchases. The value of the participant s annual contribution is loaded on the Card, and amounts of qualified purchases will be automatically deducted from your account. The Card may be used for eligible flexible spending account (FSA) expenses as determined by Section 213(d) of the Internal Revenue code. You may use the Card for co-pays at hospitals, physician offices, pharmacies, dental offices, vision service locations, and wherever they accept MasterCard or Visa cards. When using your debit card, make sure the merchant provides you with a statement/invoice of the transaction. A sales receipt is not considered valid documentation, and you will be asked to provide a more detailed receipt for substantiation. A written notification may be sent by or regular mail requesting that a copy of the invoice be submitted to MGM to ensure the expense is allowable based on IRS guidelines. You may also view notification requests with the reason for denial in your personal website account. Only eligible expenses incurred during the current plan year and/or grace period can be claimed as eligible expenses. Recent legislation requires that a doctor s prescription for OTC drugs and medicines is required prior to reimbursement. The debit card can be used to purchase an allowable OTC when a doctor s prescription is obtained and a prescription number assigned and dispensed by a pharmacist. Please refer to the sections on Over the Counter (OTC) Items and OTC Expenses for more information. Personal care items are not eligible for Card use. 22
23 Online Claim Filing Logon to From the participant home page, access the option for Online Claims under the Accounts tab to file your claims online 23
24 Online Claim Form Enter all requested information to process your claim and submit to MGM for processing. 24
25 Manual Claims Claim forms for Health Care FSA and Dependent Care FSA may be downloaded from the participant website. Under the Forms Tab, choose the applicable form for your claim. Complete the correct reimbursement claim form (please use the form available on the MGM home page or your participant website. Outdated or altered claim forms will not be accepted for processing) The claim information must be written on the form. Forms with See Attached will not be processed for reimbursement Submit an Explanation of Benefits (EOB) or your valid documentation Make copies of your documentation and/or EOB for submission to MGM Do not send your original documentation, retain originals for your records Fax or mail to MGM for processing You can elect to receive your reimbursement by direct deposit or check 25
26 How to Substantiate Claims Submit valid documentation for Flex Expenses Health Care Claims: The Internal Revenue Service requires that ALL health care claims be documented for approval in order to be eligible for reimbursement. Valid substantiation documentation for health care expenses will have the following: Name of service provider Name of patient Date of service or sale Description of service or product Amount of unreimbursed service or sale 26
27 Invalid Substantiation A sales receipt normally shows only the date and amount of a transaction. These receipts do not provide the patient s name, a description of the service or show the actual date the service was performed. Dependent care claims: Valid substantiation documentation for dependent care claims may be in the form of a receipt from the day care provider that shows: Dependent s name Provider name and information Description of service Date span of service (i.e., January 1-31, 2010; not the same as the paid date) Amount of reimbursement Example of invalid documentation for Flex Expenses A sales receipt is not valid substantiation documentation based on IRS guidelines 27
28 Debit Card Auto-Substantiation If your employer provides the MGM Flex Card for your health FSA, you may be asked to provide documentation to substantiate certain expenses charged on the Flex Card. Prescription drugs, over-the-counter items and other FSA approved items. You can use your Flex Card to purchase these items at merchant s locations that have obtained a certification from IRS. These merchants belong to an IIAS (Inventory Information Approval System) network. When you purchase eligible items from these merchants, your Flex Card is auto substantiated, and you will not be asked for documentation. Co-Payments for health related expenses. When you use your Flex Card to pay the co-pay for services from your medical provider, you will not be asked for documentation. Recurring Expenses When you have prescriptions that are filled monthly, orthodontic monthly payments or other recurring eligible expenses, you will need to provide MGM with valid substantiation documentation for the initial charge. Once the expense is approved as valid, we will mark the transaction as recurring in our administration system. It will then be auto substantiated and no further documentation will be required for the remainder of the plan year. Please remember... recurring expenses have to be approved each plan year. Online Claims When filing claims online, you will complete the information requested on the online claim form. Once all information has been supplied, print the confirmation page and mail or fax the form to MGM Benefits for processing. A copy of the substantiation documentation must be included before the claim will be processed for payment. Claims will not be processed for reimbursement until the substantiation documentation is received. Please do not the confirmation page or documentation. When filing online claims, the dates of service from your receipts must be the same date entered online. Manual Claims. Substantiation documentation must accompany the manual claim forms for health FSA and/or dependent care FSA claim forms. Please fax or mail to MGM Benefits for processing. Please use the claim form from the website. Outdated or altered forms will not be processed. Claim information must be itemized on the claim form, and those with See Attached, will be declined and participants will be asked to resubmit. When you choose the option to file your claims online or by a manual claim process, you must provide documentation to substantiate the reimbursement request. 28
29 Learn more about Flexible Spending Accounts at MGM Benefits Group 2121 N. Glenville Drive Richardson, Texas (Phone) (Fax) MGMFlex-30 (7/2011) 29
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