2015 Dental and Vision Plan Flexible Spending Account

1. 2015 Dental and Vision Plan Flexible Spending Account

2. Dental Benefits

3. Vision Benefits • $355.00 per Calendar Year per Covered Person • Benefit can be used for: • Eye exam, • Lenses (including contact lenses) and • Frames

4. Dependent Eligibility Dental & Vision • Coverage for unmarried dependent child(ren) ages 19-25will be available through calendar year of attaining age 25. (Example: Turn 25 in July, coverage until December 31) • Dependent child(ren) over 19 must be a full time student. • Orthodontia coverage will be available to covered person under age 19.

5. What is a Flexible Spending Account (FSA)? • A tax-effective, money-savings option that will help you pay for qualified health care expenses that aren’t covered by your medical plan, and for dependent care services. • Funds are deducted pre-tax from your employer pay check. • These are pre-tax dollars so they help save money (approximately 25% in tax savings when deducted from your paycheck pre-tax)

6. What is a Flexible Spending Account (FSA)? What is an FSA? • Kellogg Community College offers you an opportunity to participate in two Flexible Spending Account Programs: • Healthcare FSA or Limited Healthcare FSA (if you have an Health Savings Account) • Dependent Care FSA

7. FSA for Healthcare • Health Care Spending Account (HCSA) • For healthcare expenses if you do not have a • Health Savings Account (HSA) • Maximum amount you can contribute is $2,500 per year • Can be used for most medical expenses not covered by your health plan including: • Deductible, coinsurance, copays, prescription drugs, dental, vision, hearing and orthodontic care. Certain over-the-counter medications qualify too.

8. Limited Flexible Spending Account • If you have a Health Savings Account (HSA), the FlexibleSpending Account is limited or restricted to: • Dental expenses • Vision expenses • Medical and prescriptions only AFTER the high deductible HAS BEEN MET.

9. IRS allows $5,000 FSA for Dependent Care • Maximum amount you can contribute is $5,000 per year • Expenses are eligible for child care under age 13 or elder care for IRS dependents. • Tax ID or Social Security Number and receipt are required • Reimbursable only after services have been incurred and money has already been deducted from payroll.

10. Maximize Your Savings Potential • Plan carefully! The amount of money you want to contribute to your FSA accounts are elected in advance. • If you underestimate, you may deplete your FSA before the end of the year, losing so of your tax-savings. • If you overestimate, you risk forfeiture of any unused FSA funds. KCC allows you to roll up to $500 from the previous plan year. Mid-year election changes are not allowed without a qualifying event! (work hours reduced, birth, death, divorce)

11. Submit early! How to receive reimbursement • Submit a complete and signed FSA reimbursement form with these attachments: - A copy of the Explanation of Benefits (EOB) OR • A receipt for co-pays and an itemized cash register receipts for OTC items that do not contain a medicine or drug OR - Effective 1/1/2011, for OTC items containing a medicine or drug, an itemized cash register receipt as well as a doctor’s prescription OR - An itemized statement from your healthcare provider if you don’t have insurance coverage (for example, dental or vision services).

12. Fast and easy! Direct Deposit • Signing up for direct deposit is a fast and easy way to be reimbursed on expenses. • When you submit a claim for reimbursement, the funds will be directly deposited into your checking account. • Use the direct deposit form to sign up. • Return the form via the fax number or mailing address on the form.

13. 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 by a doctor. • Some eligible OTC items include: Bandages without antibiotic ointments, thermometers, hot/cold packs, rubbing alcohol, splints, etc. • This is only a partial list. Refer to your FSA materials, contact Meritain Health or visit www.irs.gov.

15. Questions? Email: flexonline@meritain.com Questions about your account. Web: www.mymeritain.com Check status of a claim, FSA Balances, EOB’s Call: Meritain customer service 800-748-0003