44 FINANCIAL WELLNESS You can only claim reimbursement for expenses that you and your eligible dependents incur while you are a participant in the flexible spending accounts. If you are hired during the year or begin participating due to a Qualifying Life Event, only those services incurred after the date you start contributing to your flexible spending accounts are eligible for reimbursement. Remaining contributions cannot be used in the following calendar year. Health Care Spending Account A health care spending account (HCSA) gives you a tax break on many health care expenses that are not covered by other plans. By anticipating your expenses and arranging for deductions to be made from your paycheck each pay period, you lower your tax bill. You must enroll each year, as contribution amounts are not carried forward from one year to the next. You can set aside from $120 to $3,300 each calendar year on a pre-tax basis to cover eligible health care expenses not reimbursed by any other health plan. When you incur an eligible expense during the year, you submit a claim with a copy of the receipt for reimbursement. The receipt must include the name of the individual for whom the expense was incurred, provider name, date of service, description of service, and amount. Canceled checks and credit card slips cannot be used in place of receipts. See page 45 for information on how to enroll in Auto Import for claims processed by Personify Health. You will be reimbursed with pre-tax dollars from your account. The minimum claim amount is $10 or your account balance, whichever is less. Claim forms are available at MyScrippsHealthPlan.com. Use the Flex Payment Card available from Personify Health (see page 45) or direct deposit for faster reimbursement. Coverage ends on the last day of the month in which you terminate. In the event of a Qualifying Life Event, you may be eligible to reduce or cancel your HCSA election, provided that the change is made within 31 days of the Qualifying Life Event. OTC Product Reimbursement Over-the-counter (OTC) drugs are reimbursable through your health care spending account if they are prescribed by a physician. For a list of eligible expenses, go to MyScrippsHealthPlan.com. Flexible Spending Accounts At-a-Glance ACCOUNT FEATURE HEALTH CARE SPENDING ACCOUNT DEPENDENT CARE SPENDING ACCOUNT Your Pre-Tax Contributions Minimum: $120 per year Maximum: $3,300 per year Minimum: $120 per year Maximum: $7,500 per year ($3,500 for highly compensated employees; see page 45) ($3,750 if married and filing separately) Eligible Expenses A summary list of eligible expenses is available at MyScrippsHealthPlan.com. Expenses for you, your spouse, and any dependent you list on your tax return, as well as children up to age 26, provided they have not been reimbursed by other coverage. Examples include: • Health plan deductibles, prescription, and other copays • Certain charges not covered by any plan Expenses to care for eligible dependents that allow you to work such as summer day camp, child care, before and after-school care. Eligible dependents include: • Your qualifying child(ren)* – age 12 and under • Your spouse or a qualifying child or relative*– who is physically or mentally incapable of self-care * See page 46 for additional information about a qualifying child or relative. Special Notes The expense must be incurred (not paid) during the plan year. You have until March 31st of the following calendar year to file claims for services incurred in the current calendar year.. Also, you cannot be reimbursed or seek reimbursement for the same expense from any other source. You cannot deduct reimbursed expenses on your federal income tax return or be reimbursed from any other source. You cannot use reimbursed expenses on the Earned Income Credit, which may be more advantageous if your family income is below $25,000.
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