Custom Design Benefits, Inc.5589 Cheviot

Cincinnati, Ohio 452471-800-598-2929

www.customdesignbenefits.com

PLAN BENEFIT YEAR January 1, 2013 through December 31, 2013

Southern State Community CollegeFlexible Spending Account Plan (FSA)

(Medical Reimbursement Account)

Southern State Community CollegeFlexible Spending Account

(Medical Reimbursement Account)

Eligible Medical Expense • Deductible, co-pays, co-insurance• Lasik Eye Surgery• Eyeglasses / contact lenses• Dental/Vision (member portion)• Orthodontia• Hearing Aids• Rental of medical equipment• Lab fees, x-rays• Over-the-counter items with a prescription

Dependent Care AccountYou may set aside up to $5,000 per plan year into this account.

($2,500 for married Plan members who file separate tax returns.)

Eligible Dependent Care Expenses

• Daycare expenses for IRS dependent children• Daycare expenses for IRS dependent adults•Preschool (not including Kindergarten tuition)•Latch Key Programs - up to age 13•Summer Day Camp - up to age 13

Use care when estimating your annual election amounts!

Mid-year election change is only permissible if a qualified Work/Life Status change occurs, and FSA dollars do NOT carry forward year to year.

Active employees must submit for reimbursement within 60 days of 12/31/13.

IRS Guidelines& Terms of the FSA Plan

Take Care Debit CardThe easiest way to access the funds in your FSA account is to use your take care VISA debit card. When you pay with the card, your purchase amount is deducted from the appropriate balance in your Flexible Spending Account. Certain payments will require further verification, so please hold on to your itemized bills and receipts. Custom Design Benefits will request documentation only when it is needed.

NEW FOR 2013

Cards now have three-year expiration dates

Take Care Debit CardPurchases that do not require receipts

Take Care Debit CardPurchases that may require receipts

Debit Card Purchases that always require receipts or paper claims

Complete a CLAIM FORM only if your debit card was not used.Medical

Complete required information on claim form and attach an EXPLANATION OF BENEFITS (EOB) or STATEMENT/RECEIPT detailing expenses not covered by carrier.Dependent Care

Complete required information on claim form and attach RECEIPT for expenses from Dependent Care provider.

All reimbursements are mailed to the employee at their home addressOr issued by direct deposit if banking information is on hand

How Do I Get My Money If I Didn’t Use My Debit Card?

Mail completed form and receipts to: Custom Design Benefits, Inc. 5589 Cheviot Road

Cincinnati, OH 45247Fax to 513-598-2901 OR e-mail to FlexClaims@CustomDesignBenefits.Com

 CUSTOM DESIGN BENEFIT’S ACCOUNT SERVICES • Dedicated Claims Administrator• Daily Claims Adjudication

Allows you to keep the most updated information on your account

• Check Issuing (Daily) or Debit CardDebit Cards allow you to pay certain out-of-pocket expenses on the front end but you must retain documentation for verification of purchase. We may request some receipts.

• 24/7 Account Balance InformationInternet ServicesInteractive Voice Response System

How Do I Find Out About My Flexible Spending Account & Health Reimbursement Arrangement Balances throughout the Year?

• Custom Design Hotline: Local/National 866.598.2939

• Custom Design Website: www.CustomDesignBenefits.Com

Enter your SSN# and password (You will need to set your password on the first visit only.)

Reimbursement Check The Y-T-D balance summary is provided on each reimbursement check to help manage your account

INTERNET SERVICE FLEXIBLE SPENDING ACCOUNTS

You can view: annual election amount for current & prior plan year

contributions made to FSA Account claim status and reimbursement remaining balance last payment date & amount

You can also access claim forms online at: CustomDesignBenefits.Com

Access Custom Design Benefits Websitewww.CustomDesignBenefits.com

The screen will look exactly as the outline of the next few slides. Click on the Member’s tab.

Once you see the options from the drop down box you need to access Section 125-Flex

The first time you access your personal information, you will need to establish a password

QUESTIONS???