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20152015
Dental and Vision PlanDental and Vision Plan
Flexible Spending Flexible Spending AccountAccount
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Dental Benefits
BENEFIT DESCRIPTION
BENEFIT
(Subject to Usual and Customary Charges)
CLASS A, B AND C EXPENSES COMBINED CALENDAR YEAR MAXIMUM BENEFIT
$1,100 per Covered Person
Class A-Preventive Services
Example: (routine oral exam) 80%
Class B-Basic Services
Example: (x-rays, simple extractions) 80%
Class C-Major Services
Example:(dentures and bridges) 50%
CLASS D ORTHODONTIC LIFETIME MAXIMUM BENEFIT
(Coverage is provided only for Covered Persons under age 19) $1,500 per Covered Person
Class D-Orthodontic Services
(Coverage is provided only for Covered Persons under age 19) 50%
$355.00 per Calendar Year per Covered Person
Benefit can be used for: Eye exam, Lenses (including contact lenses) and Frames
Vision Benefits
Dental & Vision
Coverage for unmarried dependent child(ren) ages 19-25 will be available through calendar year of attaining age 25.
(Example: Turn 25 in July, coverage until December 31)
Dependent child(ren) over 19 must be a full time student.
Orthodontia coverage will be available to covered person under age 19.
Dependent Eligibility
A tax-effective, money-savings option that will help you pay for qualified health care expenses that aren’t covered by your medical plan, and for dependent care services.
Funds are deducted pre-tax from your employer pay check.
These are pre-tax dollars so they help save money (approximately 25% in tax savings when deducted from your paycheck pre-tax)
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What is a Flexible Spending Account (FSA)?
What is an FSA?
Kellogg Community College offers you an opportunity to participate in two Flexible Spending Account Programs:
Healthcare FSA or Limited Healthcare FSA (if you have an Health Savings Account)
Dependent Care FSA
What is a Flexible Spending Account (FSA)?
Health Care Spending Account (HCSA)
For healthcare expenses if you do not have a
Health Savings Account (HSA)
Maximum amount you can contribute is $2,500 per year
Can be used for most medical expenses not covered by your health plan including:
Deductible, coinsurance, copays, prescription drugs, dental, vision, hearing and orthodontic care. Certain over-the-counter medications qualify too.
FSA for Healthcare
If you have a Health Savings Account (HSA), the Flexible Spending Account is limited or restricted to:
Dental expenses
Vision expenses
Medical and prescriptions only AFTER the high deductible HAS BEEN MET.
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Limited Flexible Spending Account
Maximum amount you can contribute is $5,000 per year
Expenses are eligible for child care under age 13 or elder care for IRS dependents.
Tax ID or Social Security Number and receipt are required
Reimbursable only after services have been incurred and money has already been deducted from payroll.
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IRS allows $5,000 FSA for Dependent Care
Plan carefully! The amount of money you want to contribute to your FSA accounts are elected in advance.
If you underestimate, you may deplete your FSA before the end of the year, losing so of your tax-savings.
If you overestimate, you risk forfeiture of any unused FSA funds. KCC allows you to roll up to $500 from the previous plan year.
Mid-year election changes are not allowed without a qualifying event! (work hours reduced, birth, death, divorce)
Maximize Your Savings Potential
Submit a complete and signed FSA reimbursement form with these attachments:
- A copy of the Explanation of Benefits (EOB)
OR- A receipt for co-pays and an itemized cash register receipts for OTC items
that do not contain a medicine or drug
OR
- Effective 1/1/2011, for OTC items containing a medicine or drug, an itemized cash register receipt as well as a doctor’s prescription
OR
- An itemized statement from your healthcare provider if you don’t have insurance coverage (for example, dental or vision services).
Submit early!How to receive reimbursement
Signing up for direct deposit is a fast and easy way to be reimbursed on expenses.
When you submit a claim for reimbursement, the funds will be directly deposited into your checking account.
Use the direct deposit form to sign up.
Return the form via the fax number or mailing address on the form.
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Fast and easy! Direct Deposit
The Patient Protection and Affordable Care Act of 2010 changed the rules for the purchase of Over The Counter (OTC) products.
As of January 1, 2011, FSA, HRA and HSA funds can no longer be used to purchase OTC medicine and drugs unless such medicine or drug is prescribed by a doctor.
Some eligible OTC items include:
Bandages without antibiotic ointments, thermometers, hot/cold packs, rubbing alcohol, splints, etc.
This is only a partial list. Refer to your FSA materials, contact Meritain Health or visit www.irs.gov.
FSA Reminders
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IMPORTANT DEADLINES
Plan Incur Expense Submit Claim
Health Care Account 12/31/2015 2/28/2016
Dependent Care Account 12/31/2015 2/28/2016
Email: [email protected]
Questions about your account.
Web: www.mymeritain.com
Check status of a claim, FSA Balances, EOB’s
Call: Meritain customer service 800-748-0003
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Questions?
