1. Flexible Spending Accounts Plan Overview

2. What is a Flexible Spending Account (FSA)? There are two types of FSA’s. The two types of accounts are medical and dependent care. These accounts allow employees to set aside money on a pre- tax basis to pay out of pocket expenses for medical or dependent care expenses. Enrollment is required each year to participate in the plan. Employee contributions to the plan are deducted from payroll over 24 pay periods during the year. Elections can not be changed during the year, unless the employee experiences a status change event.

3. Who is Eligible for an FSA? You are eligible to contribute to an FSA if you are: A regular full-time or part-time employee working more than 20 hours per week.

4. Why Should I Participate in a FSA? The money contributed to your account reduces your taxable income and income tax owed to the government. Allows you to set aside money to pay for medical or dependent care expenses. If participating in an High Deductible Health Plan (HDHP), money can only be set aside for dental and vision expenses. The annual contribution is available for use on January 1 of the plan year. Budget wisely. If you contribute more funds to the account than expenses incurred, the remaining balance is forfeited.

5. How Much Can I Contribute to a FSA? Contribution Limits – $2,500 Medical Flexible Spending Accounts – $5,000 Dependent Flexible Spending Accounts

6. How Do I Utilize the Money in My FSA? When seeking a reimbursement for medical, dental, prescription or vision expenses, use your debit card. If the provider does not accept debit cards, you can submit a paper claim for reimbursement. Most dependent day care providers do not offer debit card options for payment. In this case you will need to pay for the expense up front and submit a paper claim for reimbursement. Also, remember to keep all medical receipts and Explanation of Benefits (EOBs) in case of an audit by the Flexible Spending Plan administrator.

7. What Can I Use My FSA Funds For? Any “qualified medical expense” permitted under federal tax law (IRS Publication 502). Qualified medical expenses include most medical care and services, dental and vision care.IRS Publication 502 Any qualified medical expense for yourself, your spouse or your dependent children, even if they are not covered by a high-deductible health plan. Starting in 2011, over-the-counter drugs are not eligible for FSA reimbursement. Medicare deductibles and other out-of-pocket expenses

8. Frequently Asked Questions Can I have both a medical flexible spending account and a health savings account? – You can have a medical flexible spending account AND a health savings account. However, you can only have a health savings account if you are enrolled in a High Deductible Health Plan (HDHP). – If you choose to have both, you may only use the medical flexible spending account for dental and vision expenses. What happens if I can’t use all the money in my FSA? – Money that can’t be claimed out of the account will be forfeited. – Budget wisely, this is a “use it or lose it” plan!

9. How Do I File a Paper Claim? Log into the TASC website at www.tasconline.com. www.tasconline.com Click on “Download Reimbursement Request Form.” The form will be populated with your personal information. Print out the form. Fill in the information and sign the form. Fax the completed form along with the expense documentation to 608-663-2762. Claims are processed daily.

10. Can I Receive a Debit Card for my Spouse? Yes, you can. – Complete the card order form and fax to 608-245- 3623. – Please allow 10 – 14 business days for the card to be mailed to your home.

11. When is the Last Day to Submit a Claim? All expenses must be incurred in current plan year. You have until March 31 of the following year to submit claims for current year expenses. Any requests for current year reimbursements submitted after December 31, 2011 have to be submitted as paper claims. Any requests after March 31will not be honored.

12. Can I Change my Enrollment During the Year? Yes, your enrollment can be changed during the year if you experience a status change event. A status change event would be: – Spouse changes employment – Marriage – Divorce – Birth of a child – Dependent is no longer eligible under your benefits – Death of a dependent You have 30 days from the date of the event to make changes to your enrollment.