UPHS_Enrollment_Guide_FINAL

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Print this <strong>Guide</strong> Human Resources/ Benefits Locations Making Changes During the Year Contact Information Search this Document > Welcome What’s New Cost for Coverage Plan Highlights Carewise Health Programs Medical Behavioral Health Prescription Drug Vision Dental Penn Faculty Practice Flexible Spending Accounts (FSAs) Life Insurance AD&D Coverage Disability Legal Notices Welcome > Dental > Penn Faculty Practice Penn Faculty Practice There are three Penn Faculty Plan locations you can go to for dental services. The Dental Care Center 4003 Locust Street Philadelphia 215-898-4615 PENN Dental 3401 Market Street Philadelphia 215-573-8400 Please note: There is no dental card associated with this plan. PENN Dental Center At Bryn Mawr 711 Lancaster Avenue Bryn Mawr 610-520-4600 Contact Providers • PENN Faculty Practice at 215-898-4615 • Delta Dental at 800-932-0783 • Aetna DMO at 877-238-6200
Print this <strong>Guide</strong> Human Resources/ Benefits Locations Making Changes During the Year Contact Information Search this Document > Welcome What’s New Cost for Coverage Plan Highlights Carewise Health Programs Medical Behavioral Health Prescription Drug Vision Dental Flexible Spending Accounts (FSAs) Health Care FSA Dependent Care FSA Life Insurance AD&D Coverage Disability Legal Notices Welcome > Flexible Spending Accounts Flexible Spending Accounts Flexible Spending Accounts (FSAs) allow you to pay for eligible health care and/or dependent care expenses with tax-free money. You pay no federal or Social Security taxes on money in these accounts. When you enroll in a Health Care and/or Dependent Care FSA, the dollars you designate will be deducted from your paycheck on a before-tax basis and credited to your FSA. For a complete list of eligible expenses, visit www.enrollone.com/uphs. Reimbursements You can use your Health Care Flexible Spending Account Card to pay for eligible health care expenses. When you first enroll for the FSA, SHPS will mail your card. Once you activate the card, you can use it to pay for your eligible health care expenses. If you are currently enrolled in an FSA, you will receive a new card when your current card expires (the expiration date is listed on your card). You can still choose to submit paper claims instead of using the Flexible Spending Account Card. Reimbursement checks will either be mailed directly to your home or wire-transferred to an account you designate via Electronic Funds Transfer (EFT). When submitting a claim, remember to include your Explanation of Benefits (EOB) if you are filing a claim for health care expenses partially covered by an insurance plan. Please keep your receipts until your claim is validated by SHPS. Use It or Lose It! According to IRS regulations, you must forfeit any unused funds left in your Flexible Spending Account after the applicable deadline: • Health Care FSA: Any unused funds left after September 15, 2011, will be forfeited. You can submit expenses until December 31 after the plan year. • Dependent Care FSA: Any unused funds left after June 30, 2011, will be forfeited. You can submit expenses until September 30 after the plan year. Forms Health Care FSA Claim Form Dependent Care FSA Claim Form Electronic Funds Transfer Eligible Expenses Health Care FSA Dependent Care FSA Contact Your Provider SHPS at 800-678-6684
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UPHS_Enrollment_Guide_FINAL

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