 |
 |
 |
|
|
|
|
|
|
|
|
|
 |
|||||||||
 |
 |
 |
 |
 |
 |
 |
 |
 |
|
 |
 |
 |
 |
||||||
 |
|
 |
 |
|
 |
 |
|
|
HealthState PPO
HMO
Life InsuranceDentalVisionSupplemental |
||
|
|
|
Reimbursement Accounts
The state offers you three Reimbursement Accounts (also called Flexible Spending Accounts or FSAs) that can provide you with a tax break on your predictable out-of-pocket costs. Use the chart below to see how the accounts work and check out the Frequently Asked Questions; then visit the Choice Toolkit where estimator tools can help you decide if the Reimbursement Accounts have value for you.
| Medical Reimbursement Account* | Limited Purpose Medical Reimbursement Account | Dependent Care Reimbursement Account | |
|
Enroll if you have |
Not available with HIHP HMO or PPO |
Not available with Standard HMO or PPO |
|
|
How much you can contribute |
From $60 to $2,500 in pre tax dollars |
From $60 to $2,500 in pre tax dollars |
From $60 to $5,000 in pre tax dollars ($2,500 if you're married filing separate tax returns) |
|
Use the account to pay yourself back for |
Out-of-pocket medical, prescription, dental , vision and over-the-counter medication expenses:
|
Out-of-pocket dental, vision and over-the-counter medication expenses:
Not available for medical expenses |
Care for a child, disabled spouse or qualifying relative who:
|
|
How FSAs work - Easy as 1 - 2 - 3
 |
You set aside pre tax dollars from your paycheck. |
 |
You submit eligible expenses for reimbursement throughout the year. |
 |
You are reimbursed from your FSA for the eligible expenses you submit. |
How much can I save using an FSA?
If you pay federal income tax and Social Security tax, this creates about a 20% savings on most of the health or dependent care services you buy. The savings could be more - depending on your income tax rate. And yet, even when you pay no income taxes, the Social Security tax savings is about 7.5% - or $7.50 for each $100 you spend.
Estimate Carefully
Before enrolling:
- Estimate expenses carefully for the plan year – the Reimbursement Account Estimator Tools can help you do that. For health and dental, think about using the Health Plan and Dental Cost Estimators first, then use what they tell you about out-of-pocket costs for care to start your Medical Reimbursement Account estimates.
- Read about some important considerations
for making your FSA choices.
Claiming Your Reimbursement Account Benefits
You claim Reimbursement Account benefits by submitting a claim form and appropriate supporting documentation to People First by April 15.
FSAs have a "use it or lose it" policy, which means you forfeit any amounts unused and not reimbursed for services received during the Plan year. You may use what you set aside for the Plan year for services up to March 15 of the following year.
| For the: | You can use money set aside for expenses for care between: | You must file your claims by: |
|
2012 plan year |
January 1, 2012 and March 15, 2013 |
April 15, 2013 |
|
2013 plan year |
January 1, 2013 and March 15, 2014 |
April 15, 2014 |
 |
 |
 |