Harlingen CISD Cafeteria Plan Open Enrollment Harlingen, Tx - PowerPoint PPT Presentation

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Harlingen CISD Cafeteria Plan Open Enrollment Harlingen, Tx

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Medical Equipment, Hearing Aids, Diabetic Supplies. Chiropractic Services, Acupuncture ... Certain cosmetic surgical procedures are not reimbursable ... – PowerPoint PPT presentation

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Title: Harlingen CISD Cafeteria Plan Open Enrollment Harlingen, Tx


1
Harlingen CISDCafeteria Plan Open
EnrollmentHarlingen, Tx
LifeRe
2
What is aCafeteria Plan?
  • Employee Benefit Plan sponsored by HCISD
  • Authorized by Section 125 Internal Revenue Code
    (IRC)
  • Allows payment of group health, dental and vision
    premiums, eligible adult child dependent care
    expenses, and eligible unreimbursed medical
    expenses,
  • all with before tax dollars!

3
Special IRSRules Apply
  • All dollars contributed to reimbursement accounts
    must be spent before Plan Year 90-day Grace
    Period ends or those dollars will be forfeited
  • You cannot change benefit selections or
    contributions into reimbursement accounts during
    the Plan Year unless due to legal change in
    status

4
Change inStatus Rules
  • You are allowed to alter benefits or
    contributions if you have a change in legal
    status, such as
  • Marriage
  • Divorce
  • Birth or adoption
  • Death in family
  • Termination of employment
  • A spouses open enrollment

5
Medical ReimbursementAccount
  • Examples of Out-of-Pocket Expenses include . . .
  • Deductibles, Co-insurance
  • Office Visit Co-pays, Lab Fees
  • Prescription Meds Co-pays
  • Eligible Over-the-Counter Meds
  • Eyeglasses, Contact Lenses, Lasik Surgery
  • Medical Equipment, Hearing Aids, Diabetic
    Supplies
  • Chiropractic Services, Acupuncture
  • Ambulance Services
  • Orthodontic Treatment
  • Special Rules Apply

6
Medical Reimbursement Account
  • All dollars must be spent during the Plan Year or
    those dollars will be forfeited
  • Certain cosmetic surgical procedures are not
    reimbursable
  • Certain over the counter drugs or items available
    without a prescription may be reimbursable
    subject to medical necessity
  • Certain rules apply to reimbursement for
    orthodontic treatment

7
Child Dependent Care Reimbursement Account
  • Eligible Expenses include . . .
  • Child or Adult Day Care
  • Nursery Services
  • Before and After School Care
  • You may pay for these expenses with pre-tax
    dollars
  • through payroll deduction!
  • Special Rules Apply

8
Child Dependent Care Reimbursement Account
  • A Few of the Special Rules.
  • Only those dollars actually in your account will
    be reimbursed
  • All dollars must be spent during the Plan Year or
    those dollars will be forfeited
  • Dependent care expense must be work related
  • You your spouse must be employed or full time
    student
  • Child must be under Age of 13
  • You cannot change contribution during Plan Year
    unless due to legal status change
  • You cannot take Child Care Tax Credit on 1040
    I.R.S. Form

9
How Much ShouldI Withhold for the Medical
Reimbursement Account?
  • Calculate insurance co-payments, deductibles
    coinsurance amounts (major medical, dental,
    vision, etc.)
  • Calculate the annual cost of prescriptions
    eligible over-the-counter medications including
    any co-payment amounts
  • Calculate the annual cost of other eligible
    medical services, equipment supplies
  • Total these estimated costs and divide the amount
    by the number of pay checks per year you receive
  • Example 800 / 26 30.77
  • This would be your payroll deduction per paycheck
    for your medical reimbursement account.

10
How Much Should I Withhold for Child Dependent
Care Reimbursement Account
  • Calculate the annual amount you spend for adult
    or child dependent care
  • Total these estimated costs and divide the amount
    by the number of pay checks per year you receive
  • Example 800 / 26 30.77
  • This would be your payroll deduction per paycheck
    for your child dependent care reimbursement
    account.

11
How Doesthis Work?
  • Pay for medical and/or dependent care services
  • Obtain a detailed receipt for the services,
    products, or equipment you have purchased
  • Complete the Fast Claim Form and Mail or Fax to
  • LifeRe Insurance Company
  • P.O. Box 786010
  • San Antonio, TX 78278-6010
  • Fax Number (210) 357-1015
  • Fast Claim Form available from Forms Library at
    www.lifere.net
  • With proper proof of claim, reimbursement takes 3
    5 business days from LifeRes receipt of claim

12
A Wordabout Receipts
  • What Works (Acceptable Receipts)
  • Insurance Company EOBs (Explanation of Benefits)
  • Dental, Medical or Vision Itemized Receipt of
    payment (Must show date of service, service
    performed diagnostic or service code if
    appropriate and amount paid)
  • Prescription Receipts
  • Itemized Receipts naming any Over-the-Counter
    Medications
  • What Does Not Work (Unacceptable
    Receipts)
  • Cancelled Checks
  • Balance Forward Statements
  • Visa/Mastercard Receipts

13
ImportantReminders
  • Premiums are automatically deducted from each
    paycheck
  • Contributions to reimbursement accounts are
    automatically deducted from each paycheck
  • You can make changes to your benefit selections
    only once a year during open enrollment unless
    the change is due to a legal status change
  • Use it or Lose it! ---------
  • Reimbursement Dollars Forfeited at Plan Year End
    if not used

14
  • Insert Enrollment Form

15
  • Insert Group Dental Info

16
  • Insert Group Vision Info

17
Thanks!
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