Office Of Human Resources
Flexible Spending Accounts
Flexible Spending Accounts allow you to save taxes on the money you spend for uncovered medical/dental and/or dependent care expenses. You can set aside money through payroll deductions during the calendar year to pay for predictable expenses, and amounts are deducted from your gross pay before federal, state and Social Security taxes are withheld. Because you pay no taxes on your FSA deposits, you effectively increase your spendable income over the year.
Summary of the Material Modification to the Flexible Spending Account Summary Plan Description
PLAN HIGHLIGHTS
Two accounts are available: a Medical/Dental Account and a Dependent Care Account. During Open Enrollment each fall, you decide the total amount you want deposited into either or both of the FSA accounts for the next calendar year. That amount is deducted from your paychecks in equal increments throughout the year.
Once you choose your FSA deposit amount, you may not change or stop your deductions during the year unless your family status changes (due to marriage or birth of a child, for example), and the action must be consistent with the status change.
The Medical/Dental Account is used to pay for any medical and dental expenses that are not covered by insurance plans. Some of the expenses eligible for reimbursement are: deductibles and copayments under health insurance and dental plans; orthodontic care; chiropractic care; eyeglasses and contact lenses. Even many over-the-counter medications can be covered by the FSA plan. The IRS has indicated that expenses for solely cosmetic reasons or for the maintenance of general health are not eligible expenses for medical care. Such non-covered expenses include, but are not limited to, smoking cessation classes, nicotine patches, nicotine gum, and rogaine. Premiums you pay for medical and dental coverage, whether for yourself, your spouse, or a dependent, are not eligible expenses. The maximum contribution is $5,000 per year.
The Dependent Care Account is used to pay for certain dependent care expenses incurred because you (and your spouse, if married) are employed. Eligible expenses include charges for the care of dependent children age 12 and under or for elderly or disabled family members who are dependent on you for financial support. The maximum annual contribution is $5,000 and may be less under certain circumstances (e.g., the limit is $2,500 if you are married filing separately).
Claims for eligible expenses are handled by a third-party administrator (EBS Benefit Solutions) under several options:
Reimbursement Forms are available on the website (www.myebsaccount.com) or from the Office of Human Resources and may be used to submit claims for reimbursement from both FSA accounts.
Automatic Claims Transfer Option "ACT" is the process of automatically transferring medical, dental vision and drug claims from an EBA approved system, to the flex system of EBS for payment consideration. This will greatly reduce a member's need to submit paper claims.
Claims for eligible expenses must be faxed with the request for reimbursement, completed and signed to 315-671-9869. They may also be mailed to:
EBS Benefit Solutions
P.O. Box 4982
Syracuse, NY 13221
(315) 671-9896 phone
(315) 671-9869 fax
You have a 120-day period following the end of year of your Plan Year to file for reimbursement of expenses incurred in the previous Plan Year. We encourage you to file as early as possible.
You cannot switch funds between accounts.
If you terminate employment or go on an unpaid leave of absence, your deductions will stop and you may not submit claims for services incurred after your termination date or LOA start date. When you return from an unpaid leave of absence, you may resume deductions for the rest of the plan year.
IMPORTANT: Once the period for submitting claims expires, any funds remaining in your accounts must be forfeited, in accordance with Internal Revenue Service regulations. This is called the "use it or lose it" rule. Therefore, it is important to estimate your expenses carefully when you enroll in the plan.
ELIGIBILITY
You are eligible to participate in the FSA plan if you are in a full-time or academic full-time position.
ENROLLMENT
Each fall there is an Open Enrollment period for the next plan year beginning January 1. If you are eligible to participate and you do not enroll during the Open Enrollment period, you normally will not be able to enroll until the next open enrollment period. Contact the Office of Human Resources for more detailed information about the FSA Plan, eligibility and enrollment requirements, and forms or visit the EBS website.
Plan Information
http://www.ebsbenefitsolutions.com/ParticipantServices/syracuse_forms.asp
