Full Text
Flexible Spending Benefits One of the Few Gifts the IRS Gives! Discover the benefit that SAVES YOU MONEY. This perk allows you to set aside a portion of your pay—BEFORE TAXES—to cover out-of-pocket expenses in these categories: ◆ HEALTH CARE.* Eligible expenses and services include: non-cosmetic medical, dental, and vision care services; prescription medications; over-the-counter ‘medicines’ (not vitamins or supplements); orthodontics, prescription eyeglasses, contact lenses, laser eye surgery; mental health services; alternative health therapies (e.g. chiropractic, acupuncture), and MORE! Max. Annual Health Care Election: $3,200. ◆ DEPENDENT CARE.** For qualified day care expenses for eligible dependents (as defined by the IRS) under age 13, elderly dependents, and dependents with special needs. Eligible expenses include daycare, pre- school, before/after school care, day camp, elder daycare. Claim-based reimbursement plan (no benefit card); participants must submit claim(s) each plan year to receive accrued funds. Max. Annual Dep. Care Election: $5,000 per family. CAFETERIA PLAN ADVISORS 120 LONGWATER DR., SUITE 102, NORWELL, MA 02061 WWW.CPA125.COM TEL.: [PHONE REDACTED] FAX: [PHONE REDACTED] E-MAIL: [EMAIL REDACTED] City of Salem Enroll by 5/30/2024 for the 7/1/2024 – 6/30/2025 Plan Year*** Who’s Covered? You, your legal spouse, and your dependents as defined by the Internal Revenue Service, including those claimed on your tax return and adult children under age 26. Benefit Cards. New Health Care FSA enrollees will receive 2 cards that can be used at most medical facilities, dental offices, optical shops, and pharmacies to pay for eligible expenses. Keep your cards! They will reload each plan year that you enroll. Rollover Option. Health Care FSA balances—up to $640—will roll over to the next plan year as long as you re-enroll for the next plan year. Funds roll over after the 90-day run-out deadline. (Note: The max. rollover for the 2023-2024 plan year is $610; re-enrollment is required.) HSA Ineligibility. If you or your spouse have a Health Savings Account you are NOT ELIGIBLE to participate in the Health Care FSA plan. Make Your Money Go Further! depending on your tax status 30% UP TO Track Your Account and File Claims 24/7! Log in to your employee portal via our website (www.CPA125.com), or use our app: CPA Flex Mobile. Annual FSA Administrative Fees (paid via paycheck deduction) - Health Care FSA only $66.00 - Dependent Care FSA only $54.00 - Health Care FSA and Dependent Care FSA $66.00 Already in the FSA Plan? Re-enrollment is NOT automatic! Re-enroll via your online account portal—not the mobile app! Go to cpaemployee.lh1ondemand.com and log in on the LEFT side of the sign-in sign-in screen. On your account homepage, click the blue Enroll/ Re-enroll button and follow the steps to enroll for the new plan year. Be sure to click Submit at the end of the process. We recommend printing or saving your enrollment confirmation. New to the FSA Plan? Complete the “Authorization for Pre-Tax Payroll Reduction” form and send to: SCHOOL Employees - Send form to: Schools Benefits Office. CITY Employees - Send form to: City Benefits Office. If enrolled in a City-sponsored health insurance plan, the Health Care FSA fee is waived. * Not all Health Care expenses are FSA-eligible, such as: cosmetic procedures or products (e.g. Botox, teeth whitening, veneers, etc.), couples/family counseling, general health/wellness expenses toothbrushes, toothpastes, non-prescription sunglasses, gym dues, etc.), and federally non-permissible products. Some healthcare-related expenses, such as medical equipment and some services, may require a physician’s Letter of Medical Necessity in order to be FSA-eligible. Visit for more info. on specific products and services. Overnight camp and school tuition for kindergarten and above are not FSA-eligible; day camp is eligible when utilized as a form of childcare in order for the parent(s)/guardian(s) to be able to work; extra- curricular and enrichment programs/activities that aren’t daycare/childcare-based are not eligible; money paid to a childcare provider who doesn’t report it as income on their taxes is not FSA-eligible. Cafeteria Plan Advisors holds flex-spending (FSA) funds until eligible expenses are incurred and claim(s) submitted. Funds may be forfeited in accordance with IRS Publication 969 if eligible expenses are not incurred by the plan year deadline through the use of the provided debit card (if applicable) or claim submission, or the date upon which employment ends, whichever comes first.