Benefit Reference Guide - The School District of Palm Beach County

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Health Care FSA Can travel expenses for medical care be reimbursed? Travel expenses primarily for, and essential to, receiving medical care, including health care provider and pharmacy visits, may be reimbursable through your Health Care FSA. With proper substantiation, eligible expenses can include: • actual round-trip mileage • parking fees • tolls and • transportation to another city. Are prescriptions eligible for reimbursement? Yes, most filled prescriptions are eligible for Health Care FSA reimbursement, as long as you properly substantiate the expense. Proper submission of the reimbursement request is needed to ensure that the drug is eligible for reimbursement. The IRS requires the complete name of all medicines and drugs be obtained and documented on pharmacy invoices (including prescription number, date(s) of service and total dollar amount). This information must be included when submitting your request for reimbursement. Over-the-Counter Reimbursement Rules Under the Patient Protection and Affordable Care Act (PPACA) Overthe-Counter (OTC) drugs and medicines require a prescription from a doctor to qualify for reimbursement. For example, this includes such items as Digestive Aids, Allergy and Sinus drugs, Pain relief, Cold medicines, Cough medicines, Laxatives, Motion Sickness and Stomach remedies, Sleep Aids, Cold Sore, Anti-Diarrheal and Anti-Gas meds, Anti-Itch items, Baby Rash creams, Insect Bite treatments, Respiratory Treatments and Anti-Infective medications. Be sure to review your enrollment materials carefully and check www.myFBMC.com regularly for updates. Partial List of Medically Necessary Eligible Expenses* Acupuncture Ambulance service Birth control pills and devices Breast pumps Chiropractic care Contact lenses (corrective) Dental fees Diagnostic tests/health screening Doctor fees Drug addiction/alcoholism treatment Drugs Experimental medical treatment Eyeglasses Guide dogs Hearing aids and exams In vitro fertilization Injections and vaccinations Nursing services Optometrist fees Orthodontic treatment Prescription drugs to alleviate nicotine withdrawal symptoms Smoking cessation programs/treatments Surgery Transportation for medical care Weight-loss programs/meetings Wheelchairs X-rays NOTE: Budget conservatively. No reimbursement or refund of Health Care FSA funds is available for services that do not occur within your plan year and grace period. * IRS-qualified expenses are subject to federal regulatory change at any time during a tax year. Certain other substantiation requirements and restrictions may apply, and will be supplied to you following www.myFBMC.com 66
Health Care FSA Is orthodontic treatment reimbursable? Orthodontic treatment designed to treat a specific medical condition is reimbursable through your Health Care FSA if the proper documentation is provided: • a written statement, bill or invoice from the treating dentist/ orthodontist showing the type and date the service was incurred, the name of the eligible individual receiving the service, the cost for the service and • a copy of the patient’s contract with the dentist/orthodontist for the orthodontia treatment (only required if a participant requests reimbursement for the total program cost spread over a period of time). Reimbursement of the full or initial payment amount may only occur during the plan year in which the braces are first installed. For reimbursement options available under your employer’s plan, including care that extends beyond one or more plan years, refer to the information provided following your enrollment, or call Customer Care at 1-800-342-8017. Are some expenses ineligible? Expenses not eligible for reimbursement through your Health Care FSA include: • insurance premiums • vision warranties and service contracts and • cosmetic surgery not deemed medically necessary to alleviate, mitigate or prevent a medical condition. Limitation and exclusions apply for over-the-counter medications. When do I request reimbursement? You may use your Health Care FSA to reimburse eligible expenses after you have sought (and exhausted) all means of reimbursement provided by your employer and any other appropriate resource. Also keep in mind that some eligible expenses are reimbursable on the date available, not the date ordered. When are my funds available? Once you sign up for a Health Care FSA and decide how much to contribute, the maximum annual amount of reimbursement for eligible health care expenses will be available throughout your period of coverage. Since you don’t have to wait for the cash to accumulate in your account, you can use it to pay for your eligible health care expenses at the start of your deductions. Should I claim my expenses on IRS Form 1040? With a Health Care FSA, the money you set aside for health care expenses is deducted from your salary before taxes. It is always taxfree, regardless of the amount. By enrolling in a Health Care FSA, you guarantee your savings. Itemizing your health care expenses on your IRS Form 1040 may give you a different tax advantage, depending on their percentage of your adjusted gross income. You should consult a tax professional to determine the avenue that is right for you. www.myFBMC.com 67
Page 1 and 2:
2012 The School District of Palm Be
Page 3 and 4:
Table of Contents 4 What’s New fo
Page 5 and 6:
School District of Palm Beach Count
Page 7 and 8:
Enrollment Information and Deadline
Page 9 and 10:
Employee Responsibilities In this s
Page 11 and 12:
Enrollment Process In this sectioN.
Page 13 and 14:
Employee Eligibility Requirements I
Page 15 and 16: School District of Palm Beach Count
Page 17 and 18: PALM BEACH COUNTY SCHOOL DISTRICT D
Page 19 and 20: Changing Your Coverage In this sect
Page 21 and 22: Changing Your Coverage Event Major
Page 23 and 24: Event Major Medical Dental and Visi
Page 25 and 26: Benefits While on Leave of Absence
Page 27 and 28: Coverage Termination In this sectio
Page 29 and 30: Appeals In this section... • How
Page 31 and 32: Healthcare Terms I Need To Know Wha
Page 33 and 34: Medical Plan Comparison Charts Unit
Page 35 and 36: Medical Plan Contribution 2012 Empl
Page 37 and 38: Healthcare Benefits Where should I
Page 39 and 40: Healthcare Decision Tools and Resou
Page 41 and 42: Healthcare Benefits - Preventative
Page 43 and 44: Dental In this section... • Denta
Page 45 and 46: Dental Using a Pedodontist With bot
Page 47 and 48: BENEFIT Deductible Dental Commonly
Page 49 and 50: Vision In this section... • Visio
Page 51 and 52: Vision Additional Purchases and Out
Page 53 and 54: Employee Wellness In this section..
Page 55 and 56: Healthcare Benefits - Wellness Rewa
Page 57 and 58: Healthcare Benefits - Wellness Serv
Page 59 and 60: Healthcare Benefits - Online Servic
Page 61 and 62: Employee Wellness HealthyLiving-Les
Page 63 and 64: Flexible Spending Accounts Receivin
Page 65: Health Care FSA In this section...
Page 69 and 70: myFBMC Card ® In this section...
Page 71 and 72: myFBMC Card ® How do I use my myFB
Page 73 and 74: Dependent Care FSA Partial List of
Page 75 and 76: FSA Leave of Absence (LOA) Palm Bea
Page 77 and 78: Getting Answers Getting answers to
Page 79 and 80: Special Retirement Plan How Does it
Page 81 and 82: Special Retirement Plan Investment
Page 83 and 84: Information FRAUD WARNING In some s
Page 85 and 86: Special Retirement Plan All registe
Page 87 and 88: Disability Income Protection About
Page 89 and 90: Disability Income Protection When C
Page 91 and 92: Disability Income Protection 24 Pay
Page 93 and 94: Disability Income Protection 22 Pay
Page 95 and 96: Group Term Life Post-tax Benefits I
Page 97 and 98: Group Term Life Post-tax Benefits P
Page 99 and 100: CIGNA’s Will Preparation Program
Page 101 and 102: CIGNA Identity Theft Program CIGNA
Page 103 and 104: Critical Illness Insurance Plan A P
Page 105 and 106: Voluntary Universal Life Insurance
Page 107 and 108: Voluntary Universal Life Insurance
Page 109 and 110: Florida Adoption Benefit Program Pa
Page 111 and 112: COBRA Notification Important Contin
Page 113 and 114: COBRA Notification Important Contin
Page 115 and 116: Beyond Your Benefits Social Securit
Page 117 and 118:
Employee Self Service Self Service
Page 119 and 120:
INDEX 401(a) Dollars 10, 13, 25, 35
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Benefit Reference Guide - The School District of Palm Beach County

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