Custom Design Benefits, Inc. 5589 Cheviot Cincinnati, Ohio 45247 - - PowerPoint PPT Presentation
Custom Design Benefits, Inc. 5589 Cheviot Cincinnati, Ohio 45247 - - PowerPoint PPT Presentation
Custom Design Benefits, Inc. 5589 Cheviot Cincinnati, Ohio 45247 1-800-598-2929 www.customdesignbenefits.com Southern State Community College Flexible Spending Account Plan (FSA) (Medical Reimbursement Account) PLAN BENEFIT YEAR January 1,
PLAN BENEFIT YEAR January 1, 2013 through December 31, 2013
Southern State Community College Flexible Spending Account Plan (FSA) (Medical Reimbursement Account)
Southern State Community College Flexible Spending Account (Medical Reimbursement Account)
Eligible Medical Expense
- Deductible, co-pays, co-insurance
- Lasik Eye Surgery
- Eyeglasses / contact lenses
- Dental/Vision (member portion)
- Orthodontia
- Hearing Aids
- Rental of medical equipment
- Lab fees, x-rays
- Over-the-counter items with a prescription
Dependent Care Account
You may set aside up to $5,000 per plan year into this account.
($2,500 for married Plan members who file separate tax returns.) Eligible Dependent Care Expenses
- Daycare expenses for IRS dependent children
- Daycare expenses for IRS dependent adults
- Preschool (not including Kindergarten tuition)
- Latch Key Programs - up to age 13
- Summer Day Camp - up to age 13
Use care when estimating your annual election amounts!
Mid-year election change is only permissible if a qualified Work/Life Status change occurs, and FSA dollars do NOT carry forward year to year.
Active employees must submit for reimbursement within 60 days of 12/31/13.
IRS Guidelines & Terms of the FSA Plan
Take Care Debit Card
The easiest way to access the funds in your FSA account is to use your take care VISA debit card. When you pay with the card, your purchase amount is deducted from the appropriate balance in your Flexible Spending Account. Certain payments will require further verification, so please hold on to your itemized bills and receipts. Custom Design Benefits will request documentation only when it is needed. NEW FOR 2013 Cards now have three-year expiration dates
Take Care Debit Card Purchases that do not require receipts
Take Care Debit Card Purchases that may require receipts
Debit Card Purchases that always require receipts or paper claims
Complete a CLAIM FORM only if your debit card was not used. Medical Complete required information on claim form and attach an EXPLANATION OF BENEFITS (EOB) or STATEMENT/RECEIPT detailing expenses not covered by carrier. Dependent Care Complete required information on claim form and attach RECEIPT for expenses from Dependent Care provider. All reimbursements are mailed to the employee at their home address Or issued by direct deposit if banking information is on hand
How Do I Get My Money If I Didn’t Use My Debit Card?
Mail completed form and receipts to:
Custom Design Benefits, Inc. 5589 Cheviot Road Cincinnati, OH 45247
Fax to 513-598-2901 OR e-mail to FlexClaims@CustomDesignBenefits.Com
CUSTOM DESIGN BENEFIT’S ACCOUNT SERVICES
- Dedicated Claims Administrator
- Daily Claims Adjudication
Allows you to keep the most updated information on your account
- Check Issuing (Daily) or Debit Card
Debit Cards allow you to pay certain out-of-pocket expenses
- n the front end but you must retain documentation for
verification of purchase. We may request some receipts.
- 24/7 Account Balance Information
Internet Services Interactive Voice Response System
How Do I Find Out About My Flexible Spending Account & Health Reimbursement Arrangement Balances throughout the Year?
- Custom Design Hotline:
Local/National 866.598.2939
- Custom Design Website: