COUNTY OF COUNTY OF SANTA CRUZSANTA CRUZ

HEALTH CARE FLEXIBLE HEALTH CARE FLEXIBLE SPENDING ACCOUNTSPENDING ACCOUNT

Health Care FSAHealth Care FSA Employee-funded account for the

reimbursement of expenses not covered by insurance

Pre-tax funding of elective contributions for known, budgetable expenses

$2,400 plan year maximum benefit election

Uniform Coverage Rule: full benefit is available on any day of the Plan Year

Health Care FSAHealth Care FSA• Claims Administrator: Creative

Benefits, Inc.• www.crbenefits.com• Internet access to claims status and

account balances• Direct Deposit of claim payments is

available• Optional Health Care FSA Payment

(Debit) Card- Additional $14.40 annual fee- Annual fee for the Payment Card is deducted from the participant’s FSA account in January

Health Care FSAHealth Care FSA Eligibility for participation in the FSA:

- Employees in permanent, budgeted positions, and employees in positions defined as limited term- Employees do not have to be covered in any of the County’s group insurance plans in order to participate in the Health Care FSA- Dependents must meet IRS definitions in order for their expenses to be covered

Health Care FSAHealth Care FSA Example of Estimated Tax Example of Estimated Tax

SavingsSavingsPRE-TAX AFTER-TAX

ANNUAL SALARY $50,000 $50,000

FSA CONTRIBUTION $1,200 $0

NET TAXABLE SALARY $48,800 $50,000

TAX PERCENTAGE 20% 20%

PAYROLL TAXES $9,760 $10,000

$0 $1,200

NET ANNUAL SALARY $39,040 $38,800

OUT-OF-POCKET HEALTH CARE COSTS

Health Care FSAHealth Care FSAEXAMPLES OF ELIGIBLE EXPENSES

EXAMPLES OF INELIGIBLE EXPENSES

Services provided by a licensed health care practitioner

Vitamins and dietary supplements

Provider Co-Pays, deductibles, RX Co-Pays

Cosmetic surgery or procedures

Over-the-counter medicines and supplies

Athletic or health club memberships

Eye glasses, contact lenses and solutions, LASIK

Teeth whitening

Dental and Orthodontic expenses

Health Care FSAHealth Care FSA Expenses have to be incurred

during the Plan Year (January 1 through December 31)

Plan Year is extended 2 ½ months into the next Plan Year for eligible expenses to be incurred

Claims incurred from 1/1/08 through 3/15/09 can be reimbursed from the 2007 Health Care FSA account if a surplus exists at the end of the plan year on 12/31/07

Health Care FSAHealth Care FSA• eligible expenses will be reimbursed

from the prior year’s balance first, then from the current year’s balance

• all expenses that are to be reimbursed from the 2007 Plan Year’s election must be submitted by 3/31/08

Un-reimbursed contributions are forfeited by the plan participant

Receipts must be provided to Creative Benefits for all expenses

Flexible Benefit PlanFlexible Benefit PlanEmployee EnrollmentEmployee Enrollment

Health Care FSA enrollment cannot be changed during the plan year without a qualified status event:•Death / divorce / legal separation•Marriage•Change in number of dependents•Change in employment status

TAX CALCULATORTAX CALCULATOR

TAX CALCULATORTAX CALCULATOR

TAX CALCULATORTAX CALCULATORpassword: creativepassword: creative

TAX CALCULATORTAX CALCULATORpassword: creativepassword: creative

COUNTY OF COUNTY OF SANTA CRUZSANTA CRUZ

HEALTH CARE FLEXIBLE HEALTH CARE FLEXIBLE SPENDING ACCOUNTSPENDING ACCOUNT