Q: What can be paid through the health flexible spending plan?

A: Medical, dental, vision, and hearing expenses. NOTE: Only the amount NOT paid by insurance can be paid from your flex account.

Q: What should I use for receipts to send with my flex claim?

A: For anything that is covered by insurance whether medical, dental, or vision, you must use the Explanation of Benefits (EOBs) that you receive from your insurance company. The amount you may claim is generally listed under “Patient Responsibility”. If you use the EOB from the insurance company, it is NOT necessary to send along the invoices, statements, or cash receipts.

EXCEPTION: If your EOB states that this is an ineligible claim and your insurance will not pay anything, you will need to send an itemized invoice.

For anything that is not covered by insurance, you will need to send an itemized invoice. This invoice needs to show the following information: the patient’s name, the provider’s (doctor’s) name, the date of the service, a brief description of the service, and the amount charged. If the bill is for glasses, be sure the invoice says that they are prescription glasses or contacts.

Q: What is the “Date of Service”?

A: The date of service is the date that you actually went to the doctor, dentist, etc. It is NOT the date you receive the invoice or the date you pay the bill. In the case of mail order items (contacts or prescriptions), the date of service is considered to be the date you placed the order.

Q: When should I file my flex claim?

A: Every time you receive an EOB, or make a purchase, you should fill out and send off your claim. DO NOT wait for one more EOB, or until the end of the month, or until you have a page full.

Q: When will I be paid for my claims?

A: At the beginning of the year, nothing will be paid until you have returned to work and money is being put into your flex account. Checks MUST BE in the office by the 12^th of the month. Checks will be made and sent out by the 15^th of each month.

Q: How long do I have to get all of my claims turned in?

A: You have 60 days after the end of the year, or until February 28, to get all of the previous year’s claims turned in. If you terminate your employment, you will have 60 days after your termination date to file claims for services that were incurred prior to your term date.

Filling out your claim form:

Please be sure your name and Social Security number are at the top of the claim form. You must fill out the table with the information from your EOBs or invoices. Be sure the EMPLOYEE has signed the form at the bottom of the page.

MISCELLANEOUS INFORMATION

The balance of your flex account shows on your check stub. Statements of all your claim’s activity are mailed quarterly. You may call and get a list of all your claims at any time, if you need it.

The amount of the claim should be whatever the amount shows for your bill or Patient Responsibility, not just the amount you have available in your flex account. The full amount is posted, but you will only receive a check for whatever amount is in the flex account.

Orthodontia (braces) must be paid on a monthly basis. When your child starts orthodontia work, you need to have your dentist make a contract, which should be mailed to the flex department as soon as the orthodontia has started. The payments will be sent to you each month, provided you have set aside money in your flex account. This will carry over each year for the length of the contract.

Most dentists are familiar with this contract, but this is the information that is needed: the starting amount for the orthodontia, the date the appliances (braces) are placed, the amount and date of the down payment, insurance amount (if any), the balance for which you are responsible, the number of payments and the amount of each payment, and the starting date for the payments.

Nothing can be paid in advance.

Dependent Care – can be paid only when both parents are working the same shifts. Dependent day care expenses incurred while a parent is absent from work is not an eligible expense. Exception: temporary absences for vacation or a minor illness, etc. would be eligible for employees who pay on a weekly or monthly basis.

Eligible dependent care expenses include nursery school and pre-school or below, before or after school programs, day camps.

Dependent Care is only eligible for children 13 years old or under, unless physically or mentally incapable of self-care.

Ineligible dependent care expenses would include overnight camp, kindergarten, first grade and above, paying one dependent to care for another, or paying another parent (in the case of divorce, an ex-spouse) for the care of their child.

Dependent Care contracts can only be used when the provider charges the same whether the children are there or not. It cannot be used if you pay only when the children are at the day care provider.

FLEX ENROLLMENT FORMS

Must be in respective offices BY January 1. If they are not turned in, you are not in the flex program for that year.

Starting 2007, if you were in the flex program for 2006, your insurance and the $144.00 from the company will be automatic.

You must turn in forms if you wish to set aside money for the unreimbursed medical account or the dependent care account.

You must turn in forms if you are on your spouse’s insurance.

You must turn in forms if you were not in the flex program for 2006.

See the following page to help you better understand the information from the EOB and how to fill out your flex claim form. I hope this will help to take the “mystery” and dread out of filling out a form. Hopefully, once you have completed a form, you will see how easy the process is. Filling out the form correctly and sending in the proper receipts will assure that you receive your check when you expect to.