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FLEXIBLE SPENDING ACCOUNT (FSA) ISOLVED BENEFIT SERVICES Tax-advantaged FSAs are a great way to save money. The money you contribute to these accounts comes out of your paycheck without being taxed, and you withdraw it tax-free when you pay for eligible health care and dependent care expenses. WHAT’S AN ELIGIBLE EXPENSE? Health Care FSA – Plan deductibles, copays, coinsurance, and other health care expenses. To learn more, see IRS Publication 502 at www.irs.gov. Dependent Care FSA – Child day care, babysitters, home care for dependent elders, and related expenses. To learn more, see IRS Publication 503 at www.irs.gov. HEALTH CARE FSA • Pay for eligible health care expenses, such as plan deductibles, copays, and coinsurance. • Contribute up to $3,200 in 2024. What happens at the end of the year? Both FSAs are “Use It or Lose It” meaning if you do not spend your funds by the expense deadline, your funds will be forfeited. • Dependent Care can only be reimbursed for expenses incurred in the plan year (7/1/2024 through 6/30/2025) DEPENDENT CARE FSA Who can participate? Any employee. What are the contribution limits? Employees can contribute up to $5,000 annually per family or $2,500 if filing separately. What happens at the end of the year? FSA funds expire at the end of each year. Use it or lose it. Unlike the healthcare FSA, your full election for the plan year is not available on the day your plan starts. For the dependent care FSA, you can only be reimbursed for qualified expenses up to the amount you have contributed to your FSA up to that point in time. As your contributions accrue, claims for reimbursement can be processed. 29 • The Health Care FSA allows a 2.5-month Grace Period: Expenses can be incurred through 9/14/25 ---PAGE BREAK--- Know Your Eligible and Ineligible Expenses Estimated unreimbursed health care expenses Eligible Expenses This list is not meant to be all-inclusive, as other expenses not specifically mentioned may also qualify. Also, expenses marked with an asterisk are “potentially eligible expenses” that require a note of medical necessity from your health care provider to qualify for reimbursement. For additional information, check your Summary Plan Document or contact isolved Benefit Services. Baby/Child to age 13 - Lactation consultant - Lead-based paint removal* - Special formula* - Tuition: special school/teacher for disability or learning disability - Well baby/well child care Dental - Dental x-rays - Dentures and bridges - Exams and teeth cleaning - Extractions and fillings - Oral surgery - Orthodontia - Periodontal services Eyes - Eye exams - Eyeglasses and contact lenses - Laser eye surgeries - Prescription sunglasses - Radial keratotomy Hearing - Hearing aids and batteries - Hearing exams Lab Exams/Tests - Blood tests and Metabolism tests - Body scans - Cardiograms - Laboratory fees - X-rays Medications - Insulin - Prescription drugs Medical Equipment/Supplies - Air purification equipment* - Arches and other orthotic inserts - Contraceptive devices - Crutches, walkers, wheel chairs - Exercise equipment* - Hospital beds* - Mattresses* - Medic alert bracelet or necklace - Nebulizers - Orthopedic shoes* - Oxygen - Personal Protective Equipment (PPE) - Post-mastectomy clothing - Prosthetics - Syringes - Wigs* Obstetrics - Doulas* - Lamaze class - OB/GYN exams - OB/GYN prepaid maternity fees (reimbursable after date of birth) - Pre- and post-natal treatments Practitioners - Allergist - Chiropracter - Christian Science Practitioner - Dermatologist - Homeopath - Naturopath* - Osteopath - Physician - or Therapy - Alcohol and Drug addiction - Counseling (must be treating a medical condition) - Exercise programs* - Hypnosis* - Massage* - Occupational - Physical -Smoking cessation programs - Speech - Weight loss programs Medical Procedures/Services - Acupuncture - Alcohol and drug/substance abuse (inpatient treatment and outpatient care) - Ambulance - Fertility enhancement and treatment - Hair loss treatment* - Hospital services - Immunization - In vitro fertilization - Personal trainers* - Physical examination (not employment-related) - Reconstructive surgery (due to a congenital defect, accident or medical treatment) - Service animals - Sterilization/sterilization reversal - Transplants (including organ donor) - Transportation* 30 ---PAGE BREAK--- Eligible Over-the-Counter Items Note: Product categories are listed in bold face; common examples of products are listed in regular face. The following is a high-level list of over-the-counter (OTC) items that are not medicine or drugs and are eligible for purchase with Health Care FSA dollars. You can use your benefits card for these items Ineligible Expenses Note: This list is not meant to be all-inclusive The IRS does not allow the following expenses to be reimbursed the FSA, as they are not prescribed by a physician for a specific ailment. Over-the-Counter (OTC) Medicines, purchased on or after January 1, 2020, were reinstated with the passage of the CARES Act (COVID-3 Stimulus Bill) for HSAs, FSAs and Archer MSAs (unless your plan excludes OTC items). OTC items can be purchased with funds from eligible accounts without needing a prescription. Additionally, the bill expanded OTC items to include menstrual care products. Antiseptics, wound cleaners Alcohol, peroxide, Epsom salt Baby electrolytes Pedialyte, Enfalyte Denture adhesives, repair and cleansers PoliGrip, Benzodent, Efferdent Diabetes testing and aids Insulin, Ascencia, One Touch, Diabetic Tussin, insulin syringes, glucose products Sunscreen (SPF 15 and over) Contact lens or eyeglass insurance Cosmetic surgery/procedures Diagnostic products Thermometers, blood pressure monitors, cholesterol testing Elastics/athletic treatments ACE, Futuro, elastic bandages, braces, hot/cold therapy, orthopedic supports, rib belts Eye care Contact lens care Family planning Pregnancy and ovulation kits Electrolysis Marriage or career counseling First aid dressings and supplies Band Aid, 3M Nexcare, non-sport tapes Hearing aid/medical batteries Incontinence products Attends, Depend, GoodNites for juvenile incontinence Swimming lessons Sunscreen (SPF less than 15 needs RX) 31 ---PAGE BREAK--- copyright 2020 • www.isolvedbenefitservices.com/wdm Transforming e mployee experie nce for a better toda y and a better t omorr ow. The iFlexWDM App You have your phone with you all the time. Why not use the iFlexWDM App to review your account information, take a photo of the receipt and submit the claim right away? The iFlexWDM App connects you with the details • Quickly check available balances 24/7 • Access account details • View charts summarizing account(s) • Click to call or email Customer Service Provides additional time-saving options • View claims requiring receipts • Submit medical FSA and HRA claims • Take a picture of a receipt to submit for a claim • View HSA transaction details • Using Expense Tracker, enter medical expense information and support documentation to store for later use in paying claims via your health benefits website • Report a lost or stolen debit card The iFlexWDM App is easy, convenient and secure Simply login to the app using your same health benefits website username and password (or follow alternative instructions if provided to you) Follow these steps to download the iFlexWDM App 1. Visit the iTunes App Store or the Android Market and search for isolved Benefit Services WDM to download the app on your iPhone, iPad or Android. 2. Once installed, enter the Username and Password to log into your account at www.isolvedbenefitservices.com/wdm The iFlexWDM mobile app is available for free on Google Play and the App Store. 32 ---PAGE BREAK--- Using a Flexible Spending Account (FSA) is a great way to stretch your benefit dollars. You use pre-tax dollars in your FSA to reimburse yourself for eligible out-of-pocket medical and dependent care expenses. That means you can enjoy tax savings with the convenience of a prepaid benefits card. And that makes real sense. WHAT IS AN FSA? With an FSA, you elect to have your annual contribution (up to the annual limit set by the IRS) deducted from your paycheck each pay period in equal installments throughout the year. The amount of your pay that goes into an FSA will not count as taxable income, so you will have immediate tax savings. FSA dollars can be used during the plan year to pay for qualified expenses and services. Please check with your employer to see what plans are offered. A Health FSA allows reimbursement of qualifying out-of-pocket medical expenses. A Limited Purpose Health FSA is compatible with a Health Savings Account (HSA). A limited FSA only allows reimbursement for preventive care, vision and dental expenses, keeping the employee eligible to contribute to an HSA. A Dependent Care FSA allows reimbursement of dependent care expenses, such as day care, incurred by eligible dependents. With all FSA account types, you’ll receive access to a secure, easy-to-use web portal where you can track your account balance, view your investment accounts and submit requests for reimbursements. In addition, your plan might offer a convenient prepaid benefits card to make it easy to pay for eligible services and products. When you use the card, payments are automatically withdrawn from your account, so there are no out-of-pocket costs and you likely won’t have to submit receipts to verify the purchase. Just swipe the card and go. It’s that easy! Throughout the year, you’ll likely find yourself with expenses for yourself and your family that insurance won’t cover. By taking advantage of a health care FSA, you can actually reduce your taxable income and reduce your out-of-pocket expenses when you use your FSA to pay for health care services and products you’d purchase anyway. Flexible Spending Accounts REAL SAVINGS. REAL SIMPLE. www.isolvedbenefitservices.com/wdm copyright 2020 33 ---PAGE BREAK--- Is an FSA right for me? An FSA is a great way to pay for expenses with pre-tax dollars. A Health Care FSA could save you money if you or your dependents: • Have out-of-pocket expenses like co-pays, coinsurance, or deductibles for health, prescription, dental or vision plans • Have a health condition that requires the purchase of prescription medications on an ongoing basis • Wear glasses or contact lenses or are planning LASIK surgery • Need orthodontia care, such as braces, or have dental expenses not covered by your insurance A Dependent Care FSA provides pre-tax reimbursement of out-of- pocket expenses related to dependent care. This benefit may make sense if you (and your spouse, if married) are working or in school, and: • Your dependent children under age 13 attend day care, after-school care or summer day camp • You provide care for a person of any age who you claim as a dependent on your federal income tax return and who is mentally or physically incapable of caring for himself or herself An FSA is a great way to pay for expenses with pre-tax dollars. • Enjoy significant tax savings with pre-tax contributions and tax-free distributions used for qualified plan expenses • Quickly and easily access funds using the prepaid benefits card at point of sale, or request to have funds directly deposited to your bank account via online or mobile app • Reduce filing hassles and paperwork by using your prepaid benefits card • Enjoy secure access to accounts using a convenient Consumer Portal available 24/7/365 • Manage your FSA “on the go” with an easy-to- use mobile app • File claims easily online (when required) and let the system determine approval based on eligibility and availability of funds • Stay up to date on balances and action required with automated email alert and convenient portal and mobile home page messages • Get one-click answers to benefits questions PLAN AHEAD Before you enroll, you must first decide how much you want to contribute to your account(s). You will want to spend some time estimating your anticipated eligible medical and dependent care expenses for the calendar year. As of October 31, 2013 the US Treasury Department modified its Health Flexible Spending Account (FSA) Use- or-Lose rule to allow up to a $550 carryover of Health FSA funds. The carryover option is based solely on your employer’s plan design. Not every company allows a carryover. Some employer plans may establish a lower maximum limit than $550 , but it must be uniformly applied to all eligible participants. The carryover is applicable only to Health FSAs (not to Dependent Care FSAs). Any unused amount above the carryover limit is subject to forfeiture and cannot be cashed out or transferred to other taxable or nontaxable benefits HSAs). With the convenience of a mobile device, you can see your available balance anywhere, anytime as well as file claims and upload receipts. [EMAIL REDACTED] or [PHONE REDACTED] For questions, contact us at: copyright 2020 www.isolvedbenefitservices.com/wdm 34