Transcript Quarto Numeri Romani Adhibentur

Benefits Officers
Workshop
JW Marriott
Washington, DC
October 29, 2003
Welcome &
Introductions
OPM FSA Implementation Team
• Frank Titus, Assistant Director for
Insurance Services
• Laurie Bodenheimer, Project Leader
• Jennifer Hirschmann, Project Leader
FSAFEDS Program Team
• Sherry Tedesco, VP, Client Services,
SHPS
• Wendy Warren, Client Services Manager
• Tom Brown, Marketing Program Manager
Today’s Agenda
FSAFEDS Background
Program Overview
FSAFEDS Communications
Plan Allotments
Enrollment
Eligible Expenses
Claims & Reimbursement
Q&A
FSAFEDS Background
FSAFEDS: A Bush
Administration Initiative
President Bush is committed to
enabling government to compete more
effectively with the private sector for
the talent needed to fill the ranks of
the U.S. civil service
May 2002: Kay Coles James,
Director of OPM, decides to offer
FSAs government-wide
SHPS, Inc.
OPM selects SHPS, Inc. as FSA TPA
Leading FSA administrator
• Financially strong
• 300 FSA clients nationally;
800,000+ participants
• 9 service centers
• Technology leader
SHPS Responsibilities
as TPA
Communications
Enrollment
Eligibility
Payroll provider interface
Reconciliation
Claims processing
Customer service & support
Initial FSAFEDS
Open Season
2nd half 2003
Modest expectations
• Narrow window after contract award
• Ongoing discussions
with agencies on fees
30,000 enrolled
Upcoming 2004 Open
Season
Most civilian Federal employees
eligible to enroll: 1.8 million
Program Overview
What is a
Flexible Spending Account?
Tax-favored benefit program
Pre-tax dollars for health and
dependent care
Key Benefit: Save Money!
• Discount on eligible expenses
equal to tax savings
• 20-40% savings
Cash management tool
• Money available for eligible expenses
when you need it
Annual Tax Savings
Example
Annual Pay
Pre-Tax FSA
Contribution
WITH FSA
WITHOUT FSA
$50,000
$50,000
2,000
-0-
Taxable Income
48,000
50,000
Federal Income &
Social Security Taxes
11,842
12,495
Post-tax Dollars Spent
On Eligible Expenses
-0-
Spendable Income
36,158
TAX SAVINGS WITH AN FSA: $653
2,000
35,505
Your Annual Tax Savings
1. Find your Federal income tax rate, based on your expected 2004 income:
Tax
Rate
Single
Married, joint return
Head of
Household
15%
$7,001 to 28,400
$14,001 to 56,800
$10,001 to 38,050
25%
$28,401 to 68,800
$56,801 to 114,650
$38,051 to 98,250
28%
$68,801 to 143,500
$114,651 to 174,700
$98,251 to 159,100
2. Enter your total Federal tax rate:
#1 PLUS 1.45% for CSRS OR 7.65% for FERS: _________%
This percentage is the discount you will get using an FSA
for eligible health care and dependent care expenses.
3. Enter your planned FSA contribution for 2004: $_________
4. Multiply #3 by #2. This is the amount an FSA will save you
in 2004 on eligible care expenses $___________
Two types of FSAs
Health Care FSA (HCFSA)
• For qualified medical, health care costs
not paid by FEHB or any other insurance
Dependent Care FSA (DCFSA)
• For eligible dependent care expenses
(childcare, elder care) so you
(and spouse) can work, look for work,
or attend school full-time.
How an FSA works
Determine your annual contribution
• HCFSA maximum:
$3,000/Plan Year per individual
• DCFSA maximum:
$5,000/Plan Year per household*
• $250 minimum either account
*including any child care subsidy received
How an FSA works (cont.)
Enroll in one or both FSAs
• Authorize payroll deduction
Submit claims to plan administrator
(SHPS)
• Documentation required: EOB;
detailed receipt; affidavit
Reimbursement
• EFT or check
• New in 2004: Automatic reimbursement
Eligibility for FSAFEDS
HCFSA
• Must be FEHB eligible
• Need not be enrolled in FEHB
DCFSA
• Almost all Federal employees eligible
• Need not be FEHB eligible
• Ineligible: intermittent employees
expected to work fewer than 180 days
Administrative Fees
Nearly all agencies pay fees
for employees
• HCFSA: $4/month
• DCFSA: 1.5% of annual allotment
Financed by agencies’ employment
tax savings
FSAFEDS
Communications
Dedicated Website
WWW.FSAFEDS.COM
Key source of program information
• What’s New, FAQs
• Program literature (pdf) &
presentations (PowerPoint)
• Benefits Officers mailbox
More than just information
• Enrollment
• Participant account management (log-in)
Educating Benefits Officers
Meetings & Conferences:
• Workshop
• Network Meetings
• San Diego
Webinar
Email Blasts
Educating Employees
Brochures
Posters
Payroll Inserts / ELS Messages
Health Fairs
Presentations
Video
Email Blasts
New Hire Kits
Plan Allotments
Plan Year
Participants must enroll each Plan
Year
• FSAFEDS Plan Year = Jan 1 thru Dec 31
Salary contribution deducted equally
among pay dates in Plan Year
• Can elect accelerated deduction
Online Calculator
Interactive online calculator
• WWW.FSAFEDS.COM
Figure deductions and tax savings
Payroll Deduction Process
Employee identifies agency employer
at enrollment
FSAFEDS submits electronic file to
payroll agency with employee info,
allotment amounts
Payroll agency confirms employee
info and allotments
FSAFEDS must resolve discrepancies
prior to making reimbursements
Availability of Funds
HCFSA: total annual election is
available when 1st allotment received
by FSAFEDS
DCFSA: only amount of current
account balance is available for claim
reimbursement
“Use it or lose it”
You must forfeit money unspent after
Plan Year
• IRS Rule
Must file claims by 120 days after Plan
Year end
Plan carefully when making elections
Tracking Account Balances
Secure online account access
• WWW.FSAFEDS.COM
Call toll-free
• 1-877-FSAFEDS (372-3337)
FSAFEDS EOBs sent when claims
processed
• Email or mail
Account statements sent October and
January
Enrollment
Enroll Online
“Enroll Now” at WWW.FSAFEDS.COM
Complete online form
• Name, address, DOB, agency
• Contribution to HCFSA / DCFSA
• Election options: EFT; Automatic
reimbursement; Accelerated deductions
Personalized confirmation
Enroll By Telephone
FSAFEDS Benefits Counselors
• Toll-free 1-877-FSAFEDS (372-3337)
• TTY line: 1-800-952-0450
Provide required information
• Name, address, DOB, agency
• Contribution to HCFSA / DCFSA
• Election options: EFT; Automatic
reimbursement; Accelerated deductions
Personalized confirmation
Enrollment Options
Electronic Funds Transfer (EFT)
• Faster reimbursement than by check
Accelerated deductions
• Larger deductions from fewer paychecks
• Full allotment deducted sooner
(use for LWOP)
Enrollment Options (cont.)
Automatic reimbursement
• New in 2004
• File single claim with FEHB carrier
• Little or no paperwork to file claim
• Often no out-of-pocket payment
• Reimbursement directly to your bank
account
New Employee Enrollment
New employees have 60 days to enroll
Must enroll by October 1 of Plan Year
After October 1 wait for next
FSAFEDS / FEHB Open Season
Pre-enrollment
You know in advance you can’t enroll
in Open Season
• Reasons outside of your control
Pre-enrollment form at
WWW.FSAFEDS.COM
Deductions begin first pay date
in January
Absentee Enrollment
Missed Open Season  Belated enrollment
• Reasons outside your control
If temporary absence, enroll within 30 days
of return
Absentee enrollment form at
WWW.FSAFEDS.COM
Must file by October 1 of Plan Year
Effective day after you submit election
Enrollment Changes
May change elections any time
during Open Season
Qualified Status Change required
after Open Season
Requested change must be consistent
with event that prompts change, e.g.
• Increase DCFSA or HCFSA election after
birth or adoption of baby
• Decrease DCFSA election for day care if
spouse stays home with child
Qualified Status Change
QSCs defined by IRS:
• Change in marital status
• Change in number of dependents
• Change in dependents’ eligibility, e.g.
• Child at 13 not eligible for DCFSA coverage
• Change in cost of coverage, e.g. care fee
•
increase
Change in employment or residence status
Must notify FSAFEDS of change request
from 31 days before to 60 days after event
Qualified Status Change
Must notify FSAFEDS of change
request from 31 days before to 60
days after event
• Download QSC form at www.fsafeds.com
FSAFEDS will verify QSC
Change is effective 1st pay after
approval and verification
QSC for birth / adoption of child is
retroactive to date of event
LWOP
LWOP is a QSC only if due to military
deployment
Can prepay allotments prior to LWOP
• Accelerate deductions
• Per pay deductions are larger
Or FSA account will be frozen
• No reimbursement until end of Plan Year or
return to pay status
“Catch-up” after return
• Deduction doubled until you are current
Separation
DCFSA balance available for expenses
incurred until end of Plan Year
HCFSA terminates at separation
• Expenses incurred prior to separation
are eligible for reimbursement
Eligible Expenses
HCFSA Eligible Expenses
Health care expenses not paid
by insurance or other.
• Expenses incurred by you and your
dependents are eligible
Typical HCFSA Expenses
New in 2004: Over-the counter medications
Acupuncture
Childbirth classes
Chiropractic care
Co-payments, coinsurance and deductibles
(but not premiums)
Expenses that exceed medical,
dental, vision plan limits
• Dollar or visit maximums; out-of-network
providers
Typical HCFSA Expenses
Dental care
• Including crowns, endodontic services,
implants, oral surgery, periodontal services,
sealants
Eye exams, glasses, contact lenses
• Including prescription sunglasses
Hearing aids
Home medical equipment
(wheelchairs, oxygen, respirators, etc.)
Infertility treatments
Typical HCFSA Expenses
(cont.)
Laser eye surgery
Occupational therapy
Orthodontia
Orthotics
Prescription drugs
Preventive care
Smoking cessation programs
Typical HCFSA Expenses
(cont.)
Specialized equipment or services
for disabled persons
• Automobile equipment
• Braille books and magazines
• Guide or companion animals
• Home alert systems for visual/hearing
impaired persons
• Note takers or ASL interpreters
• Tape recorder and typewriter for
visually impaired
Typical HCFSA Expenses
(cont.)
Psychotherapy
Speech Therapy
Transportation expenses related to
medical care
Well-baby and well-child care
Whirlpool baths *
Wigs for hair loss from disease *
* With M.D.’s certification
Ineligible HCFSA Expenses
Cosmetic services (unless required by
disease or illness)
Expenses you claim on your tax return
Expenses reimbursed by other sources(e.g.
insurance)
Fees for exercise or health clubs
Hair transplants
Insurance premiums, including LTC
Weight loss programs for general wellbeing
DCFSA Eligible Expenses
Dependent care expenses that let you
(and spouse):
• Work
• Look for work
• Attend school full-time.
Services cannot be provided by your
dependent
Typical Dependent
Care Expenses
Child care at day camp, nursery school, by
a private sitter
Late pickup fees
Before- and after-school care
(but not tuition)
Care of an incapacitated adult living with
you
A housekeeper who also cares for an
eligible dependent
Ineligible DCFSA Expenses
Education or tuition fees
Late payment fees
Overnight camps
Agency fees for finding a care provider
Sports lessons, field trips, clothing
Transportation to/from the care provider
Claims & Reimbursement
Claim Forms
Available online
• WWW.FSAFEDS.COM
Or by telephone
• 1-877-FSAFEDS
FAX or mail claim to FSAFEDS (SHPS)
Required Documentation:
HCFSA
Explanation of Benefits form (EOB)
• From FEHB carrier
• Co-pays require receipt and
notation on claim
• Receipts acceptable with signed
affidavit on form
Required Documentation:
DCFSA
Copy of bill or receipt; or
Provider signs affidavit on claim form
Provider’s tax ID or SSN required
Availability of Funds
HCFSA: total annual election is
available when 1st allotment received
DCFSA: only amount of current
account balance is available for claim
reimbursement
Reimbursement Reminders
Expenses are incurred on date of
service, not when expense is paid
Expense must be incurred in
Plan Year
Claims must be postmarked by April
30 after Plan Year end
• Unclaimed funds are then forfeited
Contact Us
WWW.FSAFEDS.COM
[email protected]
• Dedicated Benefits Officers mailbox
1-877-FSAFEDS (372-3337)
–Benefits Counselors available
9am—9pm ET, Mon—Fri
Q&A
Thank you for joining us!