Health Care Flexible Spending Account
Administered by Benefit Consulting Group
Account Reimbursement Schedule 08-09 - Request for Reimbursement Form - Direct Deposit Form - Flex Plan Document - Medical Disclosure Authorization Form
| Administered by | Benefit Consulting Group Box 526 115 1/2 S University Mount Pleasant, MI 48804-0526 |
| Description | Pre-tax dollars contributed to an HCSA can be used by you or any of your qualified dependents for such expenses as medical and prescription drug deductibles and co-payments, glasses, contact lenses, dental expenses, and most other health care expenses that are not covered by you or your spouse's other health care plans. Some over-the-counter medications may also be reimbursable. |
| Eligibility | Federal tax rules define dependents as your spouse and children and your parents if: they reside with you, you are responsible for their expenses and you claim them as dependents on your income tax return. |
| Eligible Expenses | Any expense allowed, as a medical deduction on your income tax return is eligible for reimbursement under the FSA, as long as you do not also deduct those expenses on your income tax return. See health care expenses and over-the-counter medications. |
| Contribution | Minimum $10.00 per pay to a maximum of $5,000/annually. If both you and your spouse have access to a Health Care Spending Account, you are each eligible to deposit up to $5,000/annually in your separate accounts |
| FORFEITURE: IRS REGULATIONS | If you have funds left in the flexible spending account at the end of the plan year, and no eligible expenses to claim, you will forfeit the leftover dollars. |
| Availability | On the effective date the whole balance is available for withdrawal from the Health Care Account. |
| Direct Deposit | If you participate in a Flexible Spending Account you must establish a direct deposit account for your reimbursements. |