FLEXsmart

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FLEXsmart Benefits Plan
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Employee Benefit Systems (EBS)

• 214 North Main Street
• P.O. Box 1053
• Burlington, IA 52601

Phone [phone] Fax [phone] E-mail
flex_at_ebs-tpa.com
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What is a FLEXsmart Plan?

• Authorized by Congress in 1978. Today the
  majority of all employers offer a FLEXsmart Plan
• You set aside pre-tax dollars throughout the year
  to pay for medical, dental, and vision expenses
  not paid by your insurance (such as deductibles
  co-pays) and dependent care
• Employee Benefit to you
• Provided by your employer as an extra benefit to
  save you tax dollars
• Completely voluntary
• Payroll deducted

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Savings Example
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What Expenses are Covered ?

• Medical
• Deductibles
• Co-Insurance Payments
• Prescription Drugs
• Chiropractor Services
• Smoking Cessation Medications
• Orthodontia/Retainers
• Artificial Limbs Braces
• Lasik Surgery

• Vision Expenses
• Contact lenses, solutions and supplies, glasses
• Dental Expenses (excluding cosmetic procedures)
• OB/Fertility
• Hearing Devices
• Alcoholism Drug Treatment
• Diabetic Supplies
• Psychiatric/Psychologists Fees

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Eligible Over the Counter Items

• Pain Relievers
• Cold Medicines
• Antacids
• Allergy Medicines
• Diabetic Test Supplies
• Band-aids, Bandages,
• Gauze Pads, First Aid Kits
• Blood Pressure Monitor
• Sleeping Aids
• Thermometers

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Non-Eligible Expenses(Items that are deemed to
be merely beneficial for general health)

• Hot Tubs or Similar Equipment
• Exercise Equipment/ Fitness Memberships
• Beds, Chairs, and other Household Equipment
• Dietary, Herbal, or Nutritional Dietary
  Supplements
• Food Replacements
• Vitamins
• Toothpaste and Tooth Brushes
• Toiletries and Cosmetics

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Dependent Care

• Eligible expenses include
• Daycare
• Nanny
• Preschool
• Before and After School Care
• Summer Day Camp
• Care for mentally or physically handicapped
  dependent(s) of any age
• Dependent(s) must live in your home at least 8
  hours per day

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Dependent Care

• Ineligible Expenses
• Payment to your spouse
• Payment to your child who is under 19 at the
  close of the tax year or,
• Overnight Camps, Sport Camps, Private Schools,
  Kindergarten
• Dependent Care Expenses must be incurred before
  being reimbursed

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Dependent Care

• Maximum reimbursement per calendar year is
• 5,000 if unmarried or filing jointly
• 2,500 for a married employee filing separate tax
  returns
• Eligible Dependent Care must be for the purpose
  of allowing the employee, or the employees
  spouse, to be gainfully employed or to attend
  school full-time
• Qualified Dependents Include
• Children age 12 and under
• Disabled spouse or,
• Dependents who are physically or mentally
  incapable of self-care and regularly spend at
  least 8 hours each day in your home

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How do I pay for my Expenses?Use Your FLEXsmart
Debit Card

• The FLEXsmart Debit Card is a MasterCard that you
  can use to pay for eligible Medical and Dependent
  Care Expenses at qualified locations where
  MasterCard is accepted such as
• Physicians Offices
• Pharmacies
• Discount Stores
• Daycare Centers
• Use your FLEXsmart Debit Card for the following
• RX co-pays
• Vision co-pays and out-of-pocket amounts
• Dental deductibles and co-pays
• Orthodontic monthly payments
• Post billed medical deductibles and co-pays
• Dependent Daycare expenses
• Eligible over the counter medicines and medical
  supplies

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FLEXsmart Debit Card

• Instant access to Medical and Dependent Care
  account funds
• Eliminates manually filing claims and waiting for
  your reimbursement
• When using the card there is no PIN number. When
  given the option to choose credit or debit you
  should choose credit
• Be sure to keep all receipts just in case there
  is a question later. In some cases the computer
  may not be able to identify the item purchased
  and you will need to submit your receipt to EBS
  for IRS verification
• Extra cards are available for your spouse or
  dependent children (away at college) at a cost of
  0.00 per card.

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If I dont use my FLEXsmart Debit Card How do I
get reimbursed for my expenses?

• 1. Incur expense
• 2. Complete claim form
• 3. Send claim to EBS
• Email - flex_at_ebs-tpa.com
• Fax - [phone]
• Mail - Employee Benefit Systems
• 214 North Main Street
• Burlington, IA 52601

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Receiving Your Payment

• Payments sent to you every week via
• Direct Deposit or,
• Check mailed to your home
• Check your Personal Account Balance anytime
• You have 24 hour access to your Personal Account
• Log on to www.ebs-tpa.com and register to obtain
  access to your benefit information

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Claim Form
1. Write Your Name
2. List the Services
3. Attach Your Receipts
4. Sign the Form
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Important Messages From Uncle Sam
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Messages from Uncle Sam

• You cannot carry over FLEXsmart balances to the
  next year
• Unused funds will go back to your employer
• Funds in your Medical Account cannot apply to
  expenses in your Dependent Care Account or vice
  versa
• Because FLEXsmart deductions are taken out
  pre-tax, your FICA taxes and your Social Security
  benefits will be slightly lower
• Expenses must be for services provided during the
  Plan Year or during the 2 ½ month grace period

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Getting Started
Estimate Your Expenses Using the Worksheet
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Getting Started

• Complete an
• Enrollment
• Form

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Questions regarding FLEXsmart

• Paula Mehaffy-
• [phone] ext. 8453
• pmehaffy_at_ebs-tpa.com
• Deb Sherwood-
• [phone] ext. 8457
• dsherwood_at_ebs-tpa.com