Welcome To The City of Jacksonville s Flexible Benefits Plan
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1 Welcome To The City of Jacksonville s Flexible Benefits Plan
2 What Is A Flexible Benefits Plan? It s s a free benefit that allows you to pay your out-of of-pocket medical and/or work- related dependent care expenses TAX-FREE!
3 Tax-Free Means... You will pay NO Federal Income Tax You will pay NO Social Security Tax On many of your out-of of-pocket expenses
4 Mid-Year Election Changes Marriage, divorce or legal separation Birth or adoption of a child Gain or lose custody of a child Change in employment Death of spouse or dependent Change in dependent care providers Significant change or loss of health coverage
5 To change an election, you will need to complete a Request for Election Change Form
6 There Are Two Types of Flexible Spending Accounts Medical Flexible Spending Account (FSA) Dependent Care Flexible Spending Account (FSA)
7 Medical FSA Allows you to pay for out-of of-pocket medical, dental and vision expenses such as Deductibles Co-pays Prescription Drugs Medically necessary expenses that are not covered by insurance.
8 You May Use A Medical FSA For expenses incurred by you, your spouse or dependent children even if they are not covered by your insurance with the City! as well as many expenses that may not be covered by insurance such as glasses, contact lenses, prescription sun glasses, and orthodontics
9 You may contribute any amount to your Medical FSA The minimum contribution is $5.00 per pay period and the maximum contribution is $5,000 per year You decide how much to contribute based on your anticipated expenses from January 1 to December 31
10 Expenses Not Eligible For Reimbursement Include... Insurance Premiums Cosmetic Procedures Over the Counter items (such as Vitamins and supplements) Health Club Dues Warranties and pre- paid expenses Any Expense Incurred Prior to January 1
11 Dependent Care FSA Allows you to pay for work-related related dependent care expenses, such as... Nurseries Day Care Centers Private Sitters
12 To be eligible for dependent care For Child Care - your child must be under the age of 13 years old, or your dependent must be disabled and incapable of self-care. For Elder Care For Elder Care - you must be able to claim the individual as your dependent on your Federal Income Tax Return.
13 How To Establish An Account? 1. Carefully estimate your anticipated out-of ofpocket expenses 2. Enter the amount you want to contribute online during the City s s Annual Enrollment Period Next...
14 A Claim Kit will be sent to you which will include Claim Forms Return Envelopes and a A Reimbursement Schedule Interactive Claim Forms, your FSA Account and other information is also available at
15 When You Incur An Eligible Expense... Simply complete a Claim Form, and
16 A Reimbursement Check will be mailed directly to your home, or
17 You may elect Direct Deposit Reimbursement
18 Now you can pay using your Take Care VISA Card $6.00 Annual fee
19 How does it work? The Take Care Card can be used at any participating merchant who accepts VISA bank cards. Simply present the Take Care Card at time of payment to make qualified purchases for medical and dependent care goods and services directly from your flex account.
20 Do I need to do anything else... Keep your Receipts! Some eligible expenses paid with your Take Care Card will require follow-up by either faxing or mailing a copy of your pharmacy or provider s itemized receipt. If the cost of your expense exceeds your account balance, the transaction will be declined. You can reprocess the transaction for the actual amount remaining in your account, and pay the balance with cash, check or other form of payment. Remember, your account balance is updated daily online at
21 To Access Your Account Status Online Go To
22 Then Select
23 Then click on
24 Simply follow the prompts for New User Login to view your MyFlexOnline account.
25 Plan Year All Plan Years begin January 1 and end December 31 Each Plan will allow a 2 ½ month grace period to incur claims to use up prior year funds (through March 15 th ) Each Plan Year will allow a 90-day Filing Period for filing claims once the plan year ends (through March 31 st )
26 Important! Remember all funds must be spent by the end of the Plan Year and applicable grace period. March 15th
27 Questions? You can contact a member of the EBS/Atlanta Service Team by Calling Toll-Free or us at flex@ebsatlanta.com or contact us online at
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