Flexible Spending Account with Benny Card

The more you know about Flexible Spending Accounts

The more you save!

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An FSA is a free & voluntary benefit that allows you to set aside pre-tax dollars to reimburse out-of-pocket medical, dental, vision, and dependent care expenses.

Elections are withdrawn from your paycheck evenly throughout the year on a pre-tax basis.

Benefit: Save 25-30% on pre-tax dollars

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Per IRS regulations, the following, while not intended to be complete, illustrates examples of eligible medical or medical-related expenses. Expenses must be incurred during the Plan Year from which you are requesting reimbursement. Expenses are considered incurred when service is rendered, not when service is billed or payment is made. Expenses cannot be reimbursed in advance of the date service is rendered.

•Acupuncture •Ambulance fees •Braille – books and magazines •Breast Pump •Childbirth classes – mother-to-be expenses only; partner’s expenses not eligible •Chiropractic care •Coinsurance •Contact lens, solutions, and cleaners •Crutches •Deductibles •Dental fees •Dentures •Denture adhesives •Diagnostic testing fees •Eyeglasses, including examination fee

•Guide dog •Hearing aids and batteries •Hospital bills •Insulin and diabetic supplies •Laboratory fees •Laetrile by prescription •Nurse fees •Obstetrical expenses •Operations •Orthodontia •Orthopedic shoes •Osteopath fees •Oxygen •Physician fees •Practical nurse fees •Prescribed drugs–see cosmetic exceptions below •Psychiatric care

•Psychologist fees or individual therapy •Radial keratotomy/Laser eye surgery •Routine physicals •Special communication equipment for the deaf •Smoking cessation prescriptions •Special plumbing for the handicapped •Surgical fees •Therapeutic care for drug and alcohol addiction •Therapy treatments, prescribed •Transplants •Transportation expenses/mileage to receive medical care or services •Tuition at special school for physically or mentally impaired •Wheelchairs •X-rays

Cosmetic procedures are not eligible FSA Expenses

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Teeth Whitening Not an FSA Eligible Expense

Massages Must be Medically Necessary &

Require a Doctor’s Letter

To participate in an FSA , you must be eligible to enroll in your company’s group health insurance.

Example: You may still participate in your FSA benefit if you are eligible for your company’s group health insurance, but do not enroll because your coverage is through your spouse’s employer.

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Expenses can be incurred by: Participant Spouse Dependent

Definition of a dependent: Child up to the age of 26, does not have to live at home, does not have to be a full-time student, and may be married.

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Your entire medical FSA election is available to you on the first day of the plan year.

Example: If your plan year start date is 1/1/2015, on that same day, you are eligible to use all of the funds in your account, even though your contributions will be deducted from your payroll check throughout the year.

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Benny Card All participants receive 2 Benny Cards Mailed to the home address Cards are valid for 5 years Replacement cards cost $10

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Employee Portal Login online at www.beneflexhr.com Submit claims, view account balance, review

claim history, sign up for direct deposit, & update your profile

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BeneFlexHR Mobile App App is available for all iphones, ipads, and

Android devices. Submit FSA, TMA, and some HRA claims,

check account balances, upload pictures of receipts, and receive text alerts.

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Customer Service Office Hours 7:00 a.m. to 6:00 p.m. CST

Phone: 314-909-6979 800-631-3539 (toll free)

Email: info@beneflexhr.com

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Deadline for claims processing is Tuesday at 3:00 p.m. CST. Claims submitted by the Tuesday deadline will be paid on Thursday via check or direct deposit.

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14 Download at www.beneflexhr.com.

Click on “Employee” and then “Printable Forms”.

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OVER-THE-COUNTER ITEMS Watch for updates at www.beneflexhr.com

Eligible without a Doctor’s Prescription Example of Over-the-Counter Items that require a Doctor’s Prescription

• Asthma flow meters • Bandages • Blood pressure

monitors • Cholesterol tests • Contact lens solution • Crutches • Denture care products • Diabetes care: Blood test strips, glucose kits, monitors and testers • Eyeglasses • First Aid kits

• Gauze and gauze pads • Heart rate monitors • Heating pads • Incontinence supplies

for adults • Medical bracelets &

necklaces • Medical tape • Nebulizers • Orthopedic shoe

inserts • Sunscreen (15+ SPF) • Supports and braces • Thermometers

• Acid controllers • Allergy & Sinus • Antibiotic products • Anti-diarrheals • Anti-gas • Anti-itch & Insect bite • Anti-parasitic

treatments • Baby rash

ointments/creams • Callous and corn

removers • Cold sore remedies • Cough, cold & flu • Digestive aids • Eye drops

• Feminine anti-fungal/anti-itch

• Hemorrhoidal preps • Hydrogen peroxide • Laxatives • Nasal strips • Ointments • Pain relief • Respiratory treatments • Rubbing alcohol • Sleep aids & Sedatives • Sunburn cream • Stomach remedies • Wart removal products

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Over-the-Counter (OTC) drugs – Doctor’s prescription required When and who sold the product (date, name &

address) Type of OTC was purchased – *Must show

product or brand name Amount of charge

*If the receipt does not show the name of the product you can write the product name on the receipt.

Daycare expenses for a dependent includes; child care expenses for dependent children under the age of 13 years old or care for a dependent that is not mentally or physically able of caring for themselves .

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Examples: Before/After School Programs Summer Camps (not overnight) In-Home Daycare Adult Day Care Programs Must reside with you at least 6 or more months of the year.

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Maximum Election: $5,000 per year/per household

Individual or facility must reflect income on tax returns. Claim form must reflect a Social Security Number or Federal Tax ID Number of the provider.

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Manual claims must be submitted to BeneFLEX for reimbursement via the Employee Portal, fax, or mail.

Dependent Care elections are not loaded on the Benny Card.

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1. Must make an election each year to participate.

2. Only way to change your election during the plan year is to have a Life Changing or Qualifying Event.

Examples of a Qualifying Event: Marriage, divorce, birth of a child, adoption of a child, or spouse loses his/her job.

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10805 Sunset Office Drive, Ste. 401 St. Louis, Mo 63127

Phone: 314.909.6979 Toll Free: 800.631.3539

Email: info@beneflexhr.com Website: www.beneflexhr.com