Coulson Oil - Petro - 2022 Benefits Guide

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FLEXIBLE SPENDING ACCOUNTS CARRIER: Consolidated Admin Services <strong>Coulson</strong> offers two flexible spending account (FSA) options – the health care FSA and the dependent care FSA – that allow you to pay for eligible health care and dependent care expenses with the pre-tax dollars. Log into your account at www.consolidatedadmin.com to view your account balance(s), calculate tax savings, view eligible expenses, download forms, view transaction history, and more. HEALTH CARE FSA • Set aside pre-tax money from your paycheck to pay for eligible out-of-pocket expenses, such as deductibles, copays, and other health-related expenses, that are not paid by the medical, dental, or vision plans. • Over-the-counter (OTC) medications are eligible for reimbursement without a prescription. DEPENDENT CARE FSA • Set aside pre-tax money from your paycheck for daycare expense to allow you and your spouse to work or attend school full time. • Eligible dependents are children under age 13 or a child over 13, spouse, or elderly parent residing in your house who is physically or mentally unable to care for himself or herself. • Examples of eligible expenses are daycare facility fees, before and after-school care, and in-home babysitting fees (income must be reported by your care provider). HEALTH CARE FSA DEPENDENT CARE FSA $2,850 $5,000 $2,500 married filing jointly or single / head of household married filing separately 14
FLEXIBLE SPENDING ACCOUNTS HOW DOES AN FSA WORK? You decide how much to contribute to each FSA on a plan year basis up to the maximum allowable amounts. Your annual election will be divided by the number of pay periods and deducted evenly on a pre-tax basis from each paycheck throughout the year. You will receive a debit card from Consolidated Admin Services, which can be used to pay for eligible health care expenses at the point of service. If you do not use your debit card or if you have dependent care expenses to be reimbursed, submit a claim form and a bill or itemized receipt from the provider to Consolidated Admin Services. Keep all receipts in case Consolidated Admin Services requires you to verify the eligibility of a purchase. THINGS TO CONSIDER • Both healthcare and dependent care FSA dollars are use it or lose it. However, you have an additional two and a half months to incur and be reimbursed for expenses after the end of the plan year. • You cannot take income tax deductions for expenses you pay with your FSA(s) • You cannot stop or change your FSA contribution(s) during the plan year unless you experience a qualifying life event. SPECIAL FSA ACCOUNT FEATURES RUNOUT Runout is the 30 days after your plan year ends during which you may submit last year’s expenses to be reimbursed with last year’s FSA funds. NO GRACE PERIOD ROLLOVER You have the ability to rollover your full remaining balance from the plan year that has ended 6/30/2021 15
Page 1 and 2: 2022 BENEFITS ENROLLMENT GUIDE Effe
Page 3 and 4: CONTENTS 4 Benefits Overview 7 Medi
Page 5 and 6: BENEFITS OVERVIEW ENROLLMENT You ca
Page 7 and 8: MEDICAL INSURANCE 7
Page 9 and 10: WHICH MEDICAL INSURANCE PLAN IS RIG
Page 11 and 12: HEALTH SAVINGS ACCOUNT CARRIER: Con
Page 13: FLEXIBLE SPENDING ACCOUNTS 13
Page 17 and 18: DENTAL INSURANCE CARRIER: Delta Den
Page 19 and 20: VOLUNTARY LIFE INSURANCE 19
Page 21 and 22: VOLUNTARY LIFE INSURANCE CARRIER: M
Page 23 and 24: DISABILITY INSURANCE CARRIER: MetLi
Page 25 and 26: VOLUNTARY ACCIDENT INSURANCE CARRIE
Page 27 and 28: VOLUNTARY CRITICAL ILLNESS with CAN
Page 29 and 30: LEGAL SERVICES 29
Page 31 and 32: IMPORTANT CONTACTS BENEFIT CARRIER
Page 33 and 34: GLOSSARY Coinsurance: Your share of
Page 35 and 36: NOTES 35

Coulson Oil - Petro - 2022 Benefits Guide

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