Section 125 Flexible Spending Accounts with the Verity National Star Card

Two Types of Flexible Spending Accounts Health Care FSA Dependent Care FSA

What is a Health Care FSA? A “Health Care FSA” is a program employees can use to pay for medical expenses that are not reimbursed through insurance or any other arrangement.

Health Care FSA Eligible Expenses (If not covered by your primary medical insurance) Deductibles and Co-pays Contact Lenses Special Tests Laboratory Fees Prescription Drugs Coinsurance Psychotherapy Fertility Treatments Crutches Eyeglasses Vision Care Hearing Aid Devices Dental Expenses Optometrist Services Physical Exams Acupuncture Orthodontia X-Rays

How do I Estimate FSA Contributions in Advance? Review similar expenses over the last couple of years. Consider changes to family health care needs that may occur during the year. Use the worksheet at www.VerityNational.com/prosperitybank to balance risk of forfeiture versus tax saving opportunities. For the 2010 Plan year, the FSA plan has a minimum annual election amount of $300.00 and a maximum annual election amount of $6000.00, and if you elect less than $500 in the FSA plan there is a one time charge of $12 deducted from payroll.

What is a Dependent Care FSA? Dependent Care Accounts (DCAs) reimburse elder or child care expenses that allow the employee and his or her spouse to be “gainfully employed.” PLEASE NOTE: IRS mandates that the maximum election per household is $5000 per calendar year.

Dependent Care Eligible Expenses (For Eligible Tax Dependents) After-school care or extended day care programs Au pair Babysitter Before-school care Day Camp Elder Care Nanny Preschool / Nursery school

Do I Need to Enroll to Participate in an FSA? If you are currently enrolled and want to keep your FSA election the same you will not need to reenroll. If you are not currently enrolled or would like to make changes to your FSA election you will need to complete the online enrollment. **NOTE: If you elected less than the $300 you will need to reenroll.

Can I Participate in both Health and Dependent Care FSAs? Yes! However, IRS regulations require the accounts to operate separately. You cannot use funds from one to pay for expenses from the other.

Verity National Star Card Instant access to your account funds Automatically issued when you enroll Rarely required to pay out-of-pocket Virtually eliminates claim forms and receipts No more waiting for reimbursement checks Instant online access to your account balance

How do I Use the Card? Star Card is restricted to use for FSA-eligible services and purchases, per the IRS Smart technology allows only the appropriate account to be debited Not eligible for use at ATMs or other unqualified merchant locations

Provider doesn’t Accept Credit Cards? Pay for eligible expense(s) out-of-pocket and then... Mail, fax, or email claim form and receipt to:  Verity National Group, Inc. P.O. Box 780159 San Antonio, TX 78278 Fax: (210) 348-7112 Email: Section125_Claims@VerityNational.com

Thank You… The Verity National Star Card Team Section 125 Flexible Spending Accounts Please consider taking advantage of this convenient, cost-saving benefit… Sign Up Today! Thank You… The Verity National Star Card Team