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Flexible Spending Account, the College’s Section 125 Flex Plan

What it is

The Flex Plan provides a way for you to take advantage of the special tax benefits made available by current governmental regulations.  Through the Flex Plan you may set aside a portion of your pay to pay medical and dental insurance premiums, certain health care and dental expenses not provided through the College plans and dependent-care coverage. 

Healthcare spending accounts are established to reimburse you for eligible, out-of-pocket healthcare expenses for you and your covered dependents. These accounts are funded through scheduled payroll deductions and last for the duration of one plan year.  Holy Cross designates the year as January 1 through December 31st.  (In the event you have a remaining balance after December 31st, there is a grace period of January 1st through March 15th of the new calendar year where you are allowed to incur claims and submit them for reimbursement until April 25th.)  The maximum amount you are allowed to contribute to your account is $5,000.

Dependent care spending accounts are established to reimburse you for eligible, dependent care expenses. Eligible expenses include dependent care expenses for children under age 13, a disabled spouse, and/or a disabled relative or household member who depends on you for at least half of his or her support. These expenses must be necessary so that you, and, if you are married, your spouse can work. These accounts are also funded through scheduled payroll deductions and last for the duration of the plan year, as stated above. The IRS will allow you to contribute a maximum of $5,000 to your dependent care spending account (the IRS limits your contribution to $2,500 if you are married and filing separately).

When you enroll in a healthcare or dependent care spending account, you decide how much you want to contribute to your account during the plan year. Each payday, your contribution will be automatically deducted pre-tax from your paycheck – before income and FICA taxes are calculated.

How to enroll

Full‐time employees may join the Flex Plan for medical/dental insurance premium deductions at the time that they enroll in a medical or dental plan. (Employees may enroll in a medical or dental plan at time of hire or during the annual open enrollment for a January 1 effective date period offered by HR (usually in late November), or if they experience a qualifying event, such as loss of spouse’s benefits, divorce, etc.)   Unlike medical/dental insurance premiums reimbursement, the Flex Plan’s enrollment for health care reimbursement (prescription costs, etc.) is only allowed during the College’s annual open enrollment for a January 1 effective date -no exceptions or qualifying events.  Full-time employees may enroll in the dependent care account at the time of hire, at open enrollment for a January 1 effective date, or any time during the year if you have experienced a change in status as determined by the plan. Enrollment forms are available at the human resources department. The IRS will allow you to contribute a maximum of $5,000 to your dependent care spending account.

Use it or lose it

To be eligible for reimbursement, an expense must be incurred during the plan year, regardless of when you pay it. The Internal Revenue Code does not allow the plan to return your unused contributions to you. Your contributions cannot be transferred from one account to another or rolled into the next plan year (except as noted for the grace period, as previously mentioned under the section “What It Is.”) For this reason, it is very important that you carefully estimate your expected expenses. You must file all reimbursement claims by the end of the grace period.

All funds remaining in your account following the grace period will be lost.

Once enrolled, you cannot change your annual contribution election for health care premiums or dependent care accounts unless you experience a qualified status change, such as marriage, divorce, birth or adoption of a child, death of a dependent, or a change in your or your spouse’s employment status. You must make a new election each year during annual open enrollment if you wish to continue your participation in the spending accounts.  (Health care costs reimbursement enrollments are only offered once annually at open enrollment for a January 1 effective date.)

To receive reimbursement

Submit a completed Reimbursement Form with an itemized receipt or bill that indicates the date and type of services and the amount you’re responsible for.  You can expect to receive your reimbursement in approximately 7 business days after the due date has passed.  Reimbursement checks are delivered via campus mail, unless an employee has submitted a request to pick up their check directly from the Human Resources office.

Eligible healthcare expenses

Eligible healthcare expenses include, but are not limited to:

  • Acupuncture
  • Alcohol and substance dependency treatment
  • Birth control pills
  • Chiropractic services
  • Contacts and glasses
  • Deductibles and co-pays
  • Dentures
  • Fertility drugs and treatments
  • Hearing aids
  • Immunizations
  • Insulin and syringes
  • Laser eye surgery
  • Learning assistance for the disabled
  • Major medical copayments and deductibles (excluding insurance premiums of any kind)
  • Most medical assistance tools for disabilities, such as seeing-eye dogs and text telephones for hearing impairments.
  • Physical therapy
  • Psychiatric care
  • Speech therapy
  • Weight-loss counseling


You can also be reimbursed for many over-the-counter medical products that you purchase, including, but not limited to:

  • Allergy medicine
  • Antacids
  • Anti-diarrhea medicine
  • Bandages
  • Cold, flu and cough medicine
  • Cold/hot packs for injuries
  • Menstrual cycle pain products
  • Nasal strips
  • Smoking cessation aids
  • Pain relievers

Advice on what NOT to do when submitting a claim

  • Group your over-the-counter medicines on the form with your prescription medicines.  (Correct procedure:  Even if both over-the-counter and prescription medications are purchased at the same store/pharmacy, they must be listed separately on the form-each on its own line.)
  • Submit only a receipt for over-the-counter medications.  (Correct procedure:  Include a copy of the packaging of the medication that describes its use.  This is especially helpful for the lesser known o-t-c medications.)
  • Submit shipping charges in the claim.  Shipping charges are not reimbursable.
  • Rely on the store/pharmacy's receipt to identify reimbursable items:  Often times the receipts from stores such as CVS, Walgreens, etc., will list items that they deem reimbursable, but actually are not reimbursable from Flex.  (Items might include vitamins, supplements, as well as tax- all of which are not allowed.) If you are unsure if an item qualifies for reimbursement, please give HR a call before entering it on your form.
  • Enter “various” or nothing at all for the date fields.  (Correct procedure: Date fields must be entered for each prescription.  The date entered should be that which is listed on the RX paperwork and not the date listed on the store receipt.  Note:  If all prescription receipts are from the same store, ie CVS Pharmacy, you may enter them on one line and include a date range for the date field.  An example appears below.)


    Service Provided By
    Date Of Service
    Amount To Be Reimbursed
    Expenses For: Name And Relationship
    CVS RX
    5/12/09- 7/2/09
    220.00
    Self; Jesse Madeup, 13-son
    Target RX
    6/2/09- 6/16/09
    30.00
    Self; Callie Madeup, 17-daughter
  • List just the name of dependent in the “Expenses for” column on the form.  (Correct procedure: If the prescription is for a dependent, please include the name and age of dependent.)

 

How to submit a claim

You may submit claim forms (available in human resources) for eligible expenses incurred to:
Sue Levesque
Benefits Coordinator/Human Resources
PO Box 72/O’Kane B72

  • Documentation supplied for processing will not be returned. Photocopies are acceptable.
  • Claims cannot be processed unless ALL of the following information on the voucher is completed:  Section 1 - Name, SSN or Employee ID, Work Telephone No.; Department, Fac/Admin/Non-Exempt status is checked, and PO BOX.  Section 2-Service provided by, Date of Services, Amount to be Reimbursed, Type of Service, and Expenses For.  Also, the fields Employee’s Signature and Date must be completed.
  • If your claim listings exceed the seven rows on the form, use additional forms to list all applicable claims for that month.
  • Copies of receipts from service providers and/or the Explanation of Benefits Form from Insurance Carriers may each qualify as substantiation. For Dental claims, it is required that you submit the Explanation of Benefits form along with the receipt.  (The IRS says a valid receipt must be produced by your provider and include five specific details about the service you received: Provider Name, Date of Service, Patient Name, Service Description and Service Charge.)
  • Over-the-counter medications claims must be separate from prescriptions, even if they are from the same provider.
  • Canceled checks alone are not sufficient to document medical reimbursement claims.
  • Claim eligibility is considered based on the dates of service not dates of payment.
  • Payments will only be made directly to you. (Checks are delivered via campus mail unless you request to pick them up directly from Human Resources.)