GBS DLL booklet 2016_Flip

What happens while on a Leave
of Absence?
Medical and Limited Purpose Medical FSA
Your participation in the Medical and Limited Purpose
Medical FSA will not be affected if you are granted a paid
leave of absence by the company. Payroll deductions will
continue and you will continue to be able to use your
Flexible Medical Spending Account. If you are on an
unpaid leave of absence, your payroll contributions will
be suspended, however, you can still participate using
after-tax dollars and you can apply for reimbursement
for eligible expenses. When you return to work, your FSA
contributions will resume on a pretax basis provided you
return to the company in the same year in which your
leave of absence began. If you return to work for the
company in a subsequent year, you will have to re-enroll
in the Medical or Limited Purpose Medical FSA during
the annual benefits open enrollment period.
Dependent Care FSA
Your participation in the Dependent Care FSA will be
suspended during a leave of absence. Current federal
law does not allow you to participate in the Dependent
Care FSA during any period that you are not working,
and you cannot be reimbursed for any expenses
incurred during a leave of absence. You can resume
Dependent Care FSA contributions if you return to work
in the same year in which your leave of absence began. If
you return to work in a subsequent year, you will have to
re-enroll in the Dependent Care FSA during the annual
open enrollment.
Features for FSA Claim Submission, Online
and Mobile Tools
If you have qualifying expenses that were not paid using
your benefit card, you have three options for submitting
these expenses for reimbursement:
1. You can upload your claim online through the FSA
portal at www.benefitsolver.com.
2. You can fill out a claim form and submit it along with
your receipts via fax to 855 883 8541 or email at
flexadminstration@businessolver.com
3. You can mail in your claim form and receipts.
If you mail your claim, all FSA claim forms should
be sent to:
Section 125 Claims Department
Businessolver, Inc.
PO Box 65948
West Des Moines, IA 50265
If your claim is denied in whole or in part, you will receive
a notice from Businessolver. The notice will explain the
reason for the denial and what additional information or
documentation is required to substantiate the claim.
Online and Mobile Tools
As an FSA participant, you have access to tools and
features that allow you to easily and conveniently
manage your account:
You can use www.benefitsolver.com to:
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Check your account balance.
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Check the status of recently submitted claims.
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Submit new claims for reimbursement.
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Sign up to have your funds directly deposited into a
bank account.
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Order new or replacement benefit cards.
Avoiding Balance Forfeitures
There is some risk to contributing to an FSA. If you
do not use the money you contribute during the
calendar year to pay for expenses, you must forfeit
what is left over.
When Coverage Ends
Your participation in the Flexible Spending Account ends
when any of the following occurs:
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Your employment with the company ends.
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You retire.
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You die.
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You experience a Qualified Life Event that results in
your decision to end your participation.
Keep in mind that claims may be submitted for
reimbursement for expenses incurred before the date
your participation in the plan ended. Any funds left in the
account at the end of the calendar year and after all
eligible claims have been submitted for reimbursement
are forfeited.
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