Full Flex PlansBenefit options through the plan may be funded through a pure salary reduction of the employee's salary (with or without a salary gross-up), through employer provided credits, or a combination of the two.
GROUP PREMIUMS
The portion that the employee pays toward employer sponsored group coverage.
Flexible Spending Accounts (FSA)
INDIVIDUAL PREMIUM REIMBURSEMENT
Premiums for insurance policies that are employee owned (not employer sponsored or group sponsored through another employer). The policy may be for the benefit of the employee or any of his/her eligible dependents. NOTE: Employer credit dollars may not be used to fund this Flexible Spending Account.
Non-Eligible Expenses
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Life Insurance (whole, term, universal)
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Policies with cash surrender value or return of premium
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COBRA from a previous employer
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Policies that are owned by someone other than the employee
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Spousal premiums through the spouse's employer
DEPENDENT CARE REIMBURSEMENT
Expenses incurred for the care of eligible dependents for the time the employee (and spouse, if applicable) are at work. Expenses may be for dependent children under the age of 13 or elderly or disabled dependents of the employee.
Eligible Expenses
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Care for dependents of gainfully employed guardians.
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An individual living in the home (but not claimed as a deduction) who provides services while the employee is at work.
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Preschool.
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All latch key/Afterschool daycare programs.
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A daycare and/or baby-sitting service complying with state guidelines.
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Day camp or sports camp for the hours the parents are at work.
MAXIMUM AMOUNTS THAT MAY BE ELECTED:
- $5,000 maximum per calendar year for single or married filing jointly, $2,500 for married filing separately. Please keep in mind any amounts set aside by a spouse with a Section 125 Plan are included as part of the maximum allowed to be pre-taxed.
- If both you and your spouse have access to a Dependent Care FSA the maximum you can do combined is $5,000 per calendar year.
- The election cannot exceed the earning of the lower paid spouse.
- Full time students with one child cannot exceed $250 per month, two children or more cannot exceed $500 per month (Note: The deemed income amounts increased beginning in 2003 through December 2010. Bush era tax incentives will need to be extended by Congress or the amounts will revert back to $200 per month for one child and $400 per month for two or more children in 2011).
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GENERAL-PURPOSE MEDICAL REIMBURSEMENT
Any qualified medical expense for the employee or the employee's eligible dependents that is not covered by insurance.
Eligible Expenses (partial listing)
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Medical and dental plan deductibles and co-payments
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Mileage and parking fees associated with medical appointments
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Prescription drugs/co-payments
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Health club dues related to treatment prescribed by a Physician for a specific medical condition (Doctor's letter required)
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Vision care (eye exams, contacts, eye glasses, laser eye surgery)
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Prescription sun glasses
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Chiropractic care
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Dental expenses (exams, cleanings, fillings, crowns, etc.)
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Acupuncture
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Cost of maintaining a guide dog
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Hearing exams, hearing aids, other hearing expenses
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Orthodontia
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Chemical dependency treatment and related therapy
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Psychotherapy
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Smoking cessation programs
Non-Eligible Expenses (partial listing)
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Cosmetic surgery or prescription
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Teeth bleaching
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Marriage counseling
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Uniforms
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Funeral expenses
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Maternity clothes
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Non-prescription vitamins and over-the counter medications
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Exercise equipment
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Hygiene items
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Items for general health
MAXIMUM AMOUNTS THAT MAY BE ELECTED:
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The employer may limit the amount of benefit to be made available per plan year.
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Note: Health Care Reform mandates that in 2013, the maximum limit for General-Purpose Medical FSA and Limited-Purpose Medical FSA will be $2,500 per calendar year, with an index for inflation beginning in 2014.
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Benefits Design Group, Inc. At Risk Protection helps protect employers from potential loss in the event the employee voluntarily terminates before having had their full annual election payroll deducted.
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LIMITED-PURPOSE MEDICAL REIMBURSEMENT
Any qualified medical expense for the employee or the employee's eligible dependents that is not covered by insurance.
Eligible Expenses (partial listing)
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Dental plan deductibles and co-payments
- Vision care (eye exams, contacts, eye glasses, laser eye surgery)
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Prescription sun glasses
- Dental expenses (exams, cleanings, fillings, crowns, etc.)
- Orthodontic procedures (only if the procedure is medically necessary)
Non-Eligible Expenses (partial listing)
POST HSA DEDUCTIBLE MEDICAL REIMBURSEMENT
Any qualified medical expense for the employee or the employee's eligible dependents that is not covered by insurance.
In order to preserve HSA eligibility, it is possible to design the FSA so that it will only reimburse dental and vision expenses on a first dollar basis and will delay reimbursing any medical cost until after the employee has met the minimum required high deductible health plan deductible for the year. Once the employee has met the minimum required deductible, then the medical expenses would be reimbursable.
Benefits Design Group, Inc. offers three variations of Section 125 Flexible Benefit Plans:
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