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Martin County Sheriff's Office I Employee Benefit Highlights 12020-2021 FSA,,„„ Flexible Spending Account (Continued) FSA Guidelines - - l \ • Employee must enroll annually to participate each year. • Employee may carry over up to$550 of unused Health Care FSA HERE'S HOW IT WORKS! funds into the next plan year after a plan year ends and all claims An employee earning$30,000 elects to place$1,000 into a Health have been filed. • The Health Care FSA has a run out period at the end of the plan year Care FSA.The payroll deduction is$83.33 based on a monthly pay (30 days)to submit reimbursement on eligible expenses incurred period schedule. As a result,the insurance premiums and health care expenses are paid with tax-free dollars,giving the employee during the period of coverage within the plan year. a tax savings of$227. • When a plan year ends and all claims have been filed,all unused funds with the exception of the$550 rollover for the Health Care With a Health Without a Health FSA will be forfeited and not returned. Care FSA Care FSA • Employee can enroll in an FSA only during the Open Enrollment Salary $30,000 $30,000 period,a Qualifying Event,or New Hire Eligibility period. FSA Contribution -$1,000 -$0 • Reimbursed expenses cannot be deducted for income tax purposes. Taxable Pay $29,000 $30,000 • Employee and dependent(s)cannot be reimbursed for services not Estimated Tax -$6,568 $6,795 received. 22.65%=15%+7.65%FICA • Employee and dependent(s) cannot receive insurance benefits After Tax Expenses $0 $1,000 or any other compensation for expenses which are reimbursed Spendable Income $22,432 $22,205 through an FSA. Tax Savings , • Domestic Partners are not eligible as Federal law does not recognize them as a qualified dependent. _ Filing a Claim Please Note: Be conservative when estimating health care expenses. IRS Claim Form regulations state that any unused funds remaining in an FSA,after a plan year A completed claim form along with a copy of the receipt as proof of the ends and after all claims have been filed,cannot be returned or carried forward to the next plan year,with the exception of the$550 carry over that may be allowed expense can be submitted by mail or fax.The IRS requires FSA participants to for the Health Care FSA.This rule is known as"use-it or lose-it.” maintain complete documentation,including copies of receipts for reimbursed expenses,for a minimum of one(1)year. Discovery Benefits Debit Card Customer Service:(866)451-33991 www.discoverybenefits.com FSA participants will automatically receive a debit card for payment of eligible expenses.With the card,most qualified services and products can be paid at the point of sale versus paying out-of-pocket and requesting reimbursement. The debit card is accepted at a number of medical providers and facilities,and most pharmacy retail outlets. Discovery Benefits may request supporting documentation for expenses paid with a debit card. Failure to provide supporting documentation when requested,may result in suspension of the card and account until funds are substantiated or refunded back tothe Sheriff's Office.Please keep the issued card for use next year.Additional or replacement cards may be requested,however,a small fee may apply. 125 16 ©2016,Gehring Group,Inc.,All Rights Reserved