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2016-129N
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2016-129N
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Last modified
9/26/2016 12:02:26 PM
Creation date
9/26/2016 12:02:22 PM
Metadata
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Template:
Official Documents
Official Document Type
Plan
Approved Date
08/16/2016
Control Number
2016-129N
Agenda Item Number
8.RR.
Entity Name
IRC Board of County Commissioners
Subject
Health Care Flexible Spending Account Plan
Section 125 of Internal Revenue Code
Effective 10/1/2015
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If the Participant is eligible to receive Benefits under the Plan, he shall submit a statement stating <br /> the amount of Eligible Employment Related Expenses incurred by the Participant to the Benefit <br /> Administrator or its designee within ninety(90) days after the date participation ends within the <br /> Plan Year or the ninety(90)days after end of the Plan Year, whichever is earlier. Within thirty(30) <br /> days of receiving the statement,the Benefit Administrator or its designee shall pay the Participant <br /> the Benefits to which he is entitled under the Plan. <br /> Limitations on Benefits <br /> A Participant may not receive Benefits for Eligible Employment Related Expenses incurred for any <br /> month in excess of his Earned Income for that month. If the Participant is married, he/she may not <br /> ' receive benefits for any month in excess of the lesser of: <br /> a. his Earned Income for the month; or <br /> b. the Earned Income of his/her Spouse for that month. <br /> A Spouse who is not employed during any month in which the Participant incurs Eligible <br /> Employment Related Expenses, and is either incapacitated or a Student, shall be deemed to have <br /> Earned Income for that month of: <br /> a. $250, if there is one Qualifying Individual for whom the Participant incurs Eligible <br /> Employment Related Expenses; or <br /> b. $500, if there is more than one Qualifying Individual for whom the Participant incurs <br /> Eligible Employment Related Expenses. <br /> A Participant may not receive Benefits for Eligible Employment Related Expenses for any <br /> calendar year in excess of$5,000.00. A married Participant who files a separate individual tax <br /> return may not receive Benefits for Eligible Employment Related Expenses for any calendar year <br /> in excess of$2,500.00. <br /> Funding <br /> Contributions required to pay Benefits under this Plan shall consist of contributions by the <br /> Participant. <br /> Plan Administrator <br /> The Plan Administrator shall be the named fiduciary of the Plan and shall have the authority to <br /> manage the operation and administration of the Plan and to adopt such rules and regulations <br /> consistent with the Plan as it shall deem appropriate to administer the Plan. All determinations by <br /> the Plan Administrator shall be binding upon Participants, their spouses and dependents. <br /> 5 <br />
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