Benefits forBurke County Schools

Important FSA Information

General Account Questions

 

How will I know the balance in my Flexible Spending Accounts?

To view your balance, please visit www.healthierbenefits.com. You may also contact the Flex Department at (800) 426-8739 ext. 5052.

 

Can I change my elections in the 125 plan at any time during the plan year?

No. You cannot change your elections during the plan year unless your plan allows changes in the event of specific status changes. The following events are typically considered eligible status changes; however, your election change must be consistent with the status event:

 

Legal martial status

Number of departments

Employment status

Department satisfies or ceases to satisfy eligibility requirements

Judgment or Order to cover a child

Entitlement to Medicare or Medicaid benefits

 

Unless you are subject to one of these qualifying events, your election is irrevocable for the plan year. If you experience one of the changes noted above, please notify your Human Resources department to modify your election within 30 days of the event.

 

What happens to the funds I set aside?

If you participate in both the Health Care and Dependent Day Care FSAs, the funds you set aside are deposited into two separate accounts – one for out-of-pocket eligible health care expenses and one for dependent day care expenses. The money allocated for your Health Care Spending Account is available for immediate reimbursement up to your annual election amount. Dependent Care Spending Account dollars are reimbursed as they accumulate in your account; simply submit the required documentation. You cannot transfer or “borrow” funds from one account to the other.

 

What happens if I leave my employment during the plan year and have money left in my account(s)?

See your Human Resources Department for specifics regarding COBRA continuation of your Health Care FSA. The Department Care FSA is not eligible for COBRA continuation. If you choose not to participate in COBRA, any funds remaining in your Health Care FSA will be forfeited if you do not have sufficient eligible expenses incurred prior to termination.

 

Can I submit a claim after the plan year ends?

You will have a run-out claims period after the end of the plan year or the date your coverage period ends to submit claims that were incurred during the plan year. Your Plan Summary will indicate the exact amount of time your plan allows. The expense MUST be for services performed during the plan year.

 

Do I need to provide IMS with any documentation when I file a Department Day Care claim?

Yes, If you participate in the dependent care account, you must provide IMS with the name(s) of your child(ren), the name , tax ID number of the daycare provider (required by the IRS to be submitted with every claim) and dates of service. This information is listed on the claim form which can be obtained from your employer or online at www.healthierbenefits.com.

 

What information is required for the processing and payment of the Orthodontic claims?

Orthodontia claims require special care because the service is something incurred over two to three years. Claims will be paid according to the date of service. A copy of the orthodontia contract, documentation of an allocation of expenses over the course of the treatment program, and documentation of the amount and frequency of payments to the dentist is required. The amount of the initial application of the braces will be paid at 100%, and then monthly payments will be made for the rest of the plan year for services that are rendered during the current plan year. Expenses for orthodontia that span beyond the current plan year will not be reimbursed with funds of the current FSA account, even if the entire bill is paid up front. Orthodontia reimbursement requests require proof of payment.

 

How do I sign up for the Benefits Card?

If you enroll in the Flexible Spending Account Plan, you will be mailed a card and a Cardholder Enrollment Agreement detailing policies and procedures for its use. By signing and activating the card when you use it for the first time, you are agreeing that all card transactions will be solely for qualified expenses of the Flexible Spending Account. You will be provided with one card and one extra card for a spouse or dependent. Please indicate on the enrollment form and include the spouse or dependent’s name, date of birth and Social Security number. Your card is good for three years. The funds will be reloaded to your Benefits Card if you decide to re-enroll in the next plan year. You will need to request your spouse or dependent’s card to be activated every time you re-enroll; dependent eligibility could change from year to year.

 

If I use my Benefits Card, will I still need to keep my receipts?

Yes, always keep your itemized receipts for card transactions. There may be times when a transaction will require additional review and you will be asked to submit documentation to IMS. The Flexible Spending Account is IRS regulated and we will audit random transactions to make sure proper use of the funds.

 

Can I use my Benefits Card to pay for the entire bill at my doctor or dentist’s office?

No, the purpose of a Flexible Spending Account is to put aside pre-tax funds to pay for unreimbursed medical and/or dependent day care expenses. Your health, dental, or vision provider must bill your insurance carrier for their portion of the fee first. Your Benefits Card, however, may be used for charges that are not reimbursed by your health plan, like co-pays, coinsurance, and deductibles. After your health, dental, or vision plan has paid, you may use your Benefits Card to pay for the balance. Typically, physician, lab, or dental bills provide you the option to pay with a credit card. Select the MasterCard® option and provide the card number and expiration date as you would with your personal credit card.

 

What if my benefits Card is rejected at the point of sale for any reason or my doctor, dentist or other provider/merchant doesn’t accept MasterCard®, what should I do?

Pay for the Charge, keep your itemized receipts and submit a claim reimbursement request to IMS. The card may only be used at a medical, dental and vision facilities and pharmacies. The card will not work at department, discount or grocery stores. If you are purchasing prescriptions in these establishments, use the pharmacy check out.

You may request reimbursement for eligible expenses up to your maximum annual Health Care Spending Account election at any time during the plan year. You may request reimbursement for eligible Dependent Care Spending Account expenses only to your current contribution balance.

 

What do I do if I lose my Benefits Card or it is stolen?

If you lose your card or it is stolen, contact Interactive Medical Systems Immediately by calling 800-426-8739 extension 5052. MS will deactivate your lost/stolen card and issue you a new card. You will be issued one free extra card per plan year if it is lost or stolen. Every additional card will be at a cost to the member of $10.00 per replacement card.

 

If Interactive Medical System believes I used the Benefits Card for an ineligible expense, what steps are taken? What if I don’t respond or I don’t have supporting documentation?

IMS will make several attempts to contact you regarding the need to submit documentation for Benefits Card transactions that require review. If you do not respond to these requests or cannot provide adequate documentation of the expense, your card will be deactivated. The ineligible payment will be deducted from your future Flexible Spending Accounts claim reimbursement requests until your account is settled. You may also be asked to submit the ineligibly reimbursement back to your employer via check or payroll deduction.

 

The content of this brochure has been prepared to help you gain a better understanding of how Flexible Spending Accounts work and how you may best utilize the benefits of the Plan and does not constitute legal or tax advice. This information is an interpretation of selected portions of the Internal Revenue Code (IRC). It is informational only and not plan specific. For details of your Plan, please refer to your Plan Document.