10-10-2022 Council Packet - Laserfiche WebLink

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© Hitesman & Wold, P.A. 2019 Cafeteria Plan Summary Description (3-11) 35 (iii) is not your qualifying child or the qualifying child of anyone else (i.e., does not satisfy the requirements of paragraph (1) above with respect to any person); and (iv) is a citizen, national, or resident of the United States, or a resident of Canada or Mexico. NOTE: The definition “dependent” is different than the definition applicable under the Internal Revenue Code for purposes of identifying who you may claim as an exemption on your federal income tax return. Furthermore, an individual eligible for dependent coverage under the Group Medical Plan is not necessarily a “dependent” for purposes of the Health FSA. Additional special rules apply in some cases. For additional information, please contact the Plan Administrator or your tax advisor. (b) Rules for over-the-counter items. Eligible Expense includes certain over-the-counter items that constitute medical care even though a tax deduction is not available. Over-the- counter drugs and medicines incurred on or after January 1, 2020, no longer require a prescription to be an Eligible Expense. In addition, Eligible Expense includes expenses for the following menstrual care products incurred on or after January 1, 2020: tampons, pads, liners, cups, sponges, or similar products used by individuals with respect to menstruation or other genital-tract secretions. (c) Exceptions. Despite the general rule stated above, Eligible Expense does not include premiums for qualified long term care coverage or premiums for any group or individual health plan. IMPORTANT: Please review Exhibit A—Eligible Medical Care Expenses to help determine what is an Eligible Expense. You are also encouraged to consult your personal tax advisor or IRS Publication 502, "Medical and Dental Expenses" for further guidance as to what is or is not an Eligible Expense. CAUTION: Publication 502 addresses medical care expenses a person may deduct o n his or her income taxes. Many, but not all¸ expenses that are tax deductible are also reimbursable under the Health FSA. 5.6 How do I receive my reimbursements under the Health FSA? (a) Periodic Reimbursements. When you incur an expense that is eligible for reimbursement, you submit a claim to the Claims Administrator on a claim form that will be supplied to you. The claim form may be submitted via email, facsimile, mail, or the Claims Administrator’s website. The claim form will typically set forth: (1) the amount, date and nature of the expense ; (2) the name of the person or entity to which the expense was paid ; (3) your statement that the expense has not been reimbursed, and you will not seek reimbursement for the expense, from any other source; and (4) such other information as the Plan Administrator may require, including copies of bills or receipts from the provider(s) to support your claim.