STATE OF MAINE’S
FLEXIBLE BENEFITS PLAN
JANUARY 1 - DECEMBER 31, 2006
IN ADDITION TO THE PREMIUM PRE-TAX
BENEFIT- TWO ADDITIONAL BENEFITS
AVAILABLE EVERY PLAN YEAR –
(JANUARY 1ST - DECEMBER 31ST ) ARE:
MEDICAL EXPENSE REIMBURSEMENT ACCOUNT
DEPENDENT CARE REIMBURSEMENT ACCOUNT
ADMINISTERED BY:
H R SUPPORT & CONSULTING
SERVICES
FLEX ADMINISTRATION DEPT.
159 WATKINS SHORES RD.
CASCO, ME
04105-4309
207-655-5396 OR Toll Free 1-866-655-5397
FAX: 207-655-6636
MEDICAL CARE
REIMBURSEMENT ACCOUNTS
ALLOWS ELIGIBLE EMPLOYEES TO SET
ASIDE PRE-TAX DOLLARS TO PAY FOR
OUT OF POCKET MEDICAL EXPENSES FOR
THE PARTICIPANT AND HIS ELIGIBLE
DEPENDENTS
DEPENDENT /ELDER CARE
REIMBURSEMENT ACCOUNTS
TO BE ELIGIBLE TO USE THIS ACCOUNT
PARTICIPANT AND SPOUSE MUST:
WORK PART OR FULL TIME
ATTEND SCHOOL FULL TIME
BE ACTIVELY SEEKING WORK
CHILDCARE PROVIDER MUST BE REPORTING
THE INCOMES FOR INCOME TAX PURPOSES
HOW MUCH CAN YOU SAVE?
THE TAX SAVINGS IS DEPENDENT UPON
THE TOTAL TAXABLE HOUSEHOLD
INCOME FOR ANY GIVEN YEAR.
FOR THOSE IN A 30% TAX BRACKET, THE
TAX SAVINGS WOULD BE $300 ON EVERY
$1,000 SET INTO A REIMBURSEMENT
ACCOUNT.
ARE THERE IRS RULES TO TAKE
ADVANTAGE OF THIS PRE-TAX
BENEFIT? --- YES
THERE ARE RULES FOR THE EMPLOYER WHO
PROVIDES BENEFITS UNDER A CAFETERIA PLAN;
AND
THERE ARE RULES FOR THE EMPLOYEE WHO
ELECTS TO PARTICIPATE UNDER THE PLAN(S).
RULES FOR THE EMPLOYER:
• Must select a Plan Year. Usually coincides
with the employer’s health insurance plan
year renewal. For the State, the Plan Year is
January 1st – December 31st of each year.
___________________________
• Employer must set a medical account
maximum & minimum for the Plan Year and
requires that the amount elected by the
participant for any Plan Year be available to
him at the time he incurs the expense,
regardless of the deposits taken.
THE ANNUAL MAXIMUM
AMOUNT FOR THE STATE OF
MAINE’S MEDICAL
REIMBURSEMENT ACCOUNT IS
$2,200.00 FOR ANY PLAN YEAR.
THERE IS NO MINIMUM AMOUNT.
FOR THE MEDICAL ACCOUNT
● COBRA applies should a participant
terminate employment during a plan year
and have a positive balance in his account.
● Additionally, the employer must allow him
to continue to participate at 102% of the
participant’s salary reduction amount for the
remainder of the Plan Year.
FOR THE DEPENDENT/ELDER CARE
ACCOUNT
● IRS sets the Plan Year amount at $5,000 per
calendar year - $2,500 if married, filing
separate returns.
● The employer DOES NOT upfront the
monies for this account. The participant must
first receive the child care before he can be
reimbursed.
RULES FOR THE PARTICIPANT:
● The employee must elect to participate
each Plan Year before the plan year begins
during the State’s enrollment period.
● Once the decision to participate or not to
participate has been made, the employee is
locked into his decision for the full 12-month
Plan Year.
IMPORTANT REMINDER !!!
FOR THE STATE OF MAINE PLAN
AN ELIGIBLE EMPLOYEE CAN
ONLY ELECT TO PARTICIPATE
DURING THE ENROLLMENT
PERIOD HELD PRIOR TO THE
START OF EVERY PLAN YEAR.
ONLY PARTICIPANTS ARE ABLE TO MAKE
QUALIFYING STATUS CHANGES --
In the event that a participant has a qualifying
status change after the Plan Year has started, any
change he may want to make must be made within
30 days of the effective date of the event. The
change s/he wants to make must be consistent
with the qualifying event.
All changes must originate with the Benefits
Department representative.
WHAT KINDS OF MEDICAL EXPENSES
ARE REIMBURSEABLE?
PLEASE REFER TO THE “ALLOWABLE MEDICAL
EXPENSES” SHEET PROVIDED WITH YOUR
COMMUNICATION MATERIALS.
COMMON REIMBURSEABLE EXPENSES INCLUDE
SUCH THINGS AS CO-PAYS, DEDUCTIBLES, EYE
EXAMS, DENTAL WORK, AND PERSCRIPTION CO-
PAYS. DON’T FORGET OVER-THE-COUNTER
DRUGS AND MEDICINES.
OVER-THE-COUNTER DRUGS &
MEDICINES ARE REIMBURSEABLE!
***********************************
SEE INFORMATION MATERIALS FOR
RULES AND A PARTIAL LIST OF
QUALIFYING DRUGS AND MEDICIATIONS.
WHAT KINDS OF EXPENSES ARE NOT
ALLOWED?
● EXPENSES FOR WELLNESS, SUCH AS GYM
MEMBERSHIP OR THOSE THAT ARE COSMETIC IN
NATURE, SUCH AS TEETH WHITING ARE NOT
ALLOWABLE. ALSO, VITAMINS ARE STILL NOT ALLOWED.
● EXPENSES MUST BE TO TREAT, CURE OR MITIGATE AN
EXISTING MEDICAL CONDITION AS PER IRS
REGULATIONS.
HOW TO DETERMINE HOW MUCH
MONEY TO PUT INTO YOUR MEDICAL
REIMBURSEMENT ACCOUNT.
THE BEST WAY IS TO REVIEW YOUR
CHECKBOOK AND SEE WHAT YOU HAVE
SPENT OVER THE PAST 12-MONTHS IN
OUT-OF-POCKET MEDICAL EXPENSES.
(Jan. 1st – Dec. 31st )
THIS WILL GIVE YOU A STARTING POINT.
MAKE A LIST OF KNOWN EXPENSES FOR
YOU AND QUALIFYING DEPENDENTS FOR
SUCH THINGS AS MAINTENANCE
PERSCRIPTIONS.
LIST OTHER MEDICAL EXPENSES YOU ARE
COMFORTABLY SURE YOU WILL HAVE TO
PAY OUT-OF-POCKET OVER THE
UPCOMING 12-MONTH PLAN YEAR
JANUARY 1ST – DECEMBER 31ST , 2006. –
DON’T FORGET OVER-THE-COUNTER
DRUGS AND MEDICINES!
IF YOU’RE NEW TO THE BENEFIT, IT’S
ALWAYS WISE TO GO A LITTLE LESS THAN
ANTICIPATED TO AVOID PUTTING TOO
MUCH INTO THE ACCOUNT.
FOR THE DEPENDENT CARE ACCOUNT IT’S
EASY. -- SIMPLY DETERMINE WHAT YOU
CURRENTLY PAY FOR CHILD CARE FOR
THE 12-MONTH PLAN YEAR PERIOD.
HOW DO YOU GET REIMBURSED
AFTER ENROLLING IN THE PLAN?
COMPLETE THE “REIMBURSEMENT
REQUEST FORM” (ONE IS PROVIDED WITH
YOUR MATERIALS).
SUBMIT IT WITH YOUR RECEIPT(S) OR BILL
WHICH CONTAINS: THE NAME OF THE
PROVIDER, THE DATE OF SERVICE, THE
DOLLAR AMOUNT OWED/PAID AND A
DESCRIPTION OF THE SERVICE.
!!! IMPORTANT !!!
YOU CANNOT SUBMIT A CANCELED
CHECK AS A RECEIPT. IT IS AGAINST
IRS REGULATIONS.
*************************************
YOU MAY FAX OR MAIL YOUR FORM AND
RECEIPTS TO THE ADDRESS ON THE FORM.
CHECKS ARE MAILED THURSDAY OF EACH
WEEK TO YOUR HOME ADDRESS.
IT IS IMPORTANT THAT YOU REVIEW ALL
THE COMMUNICATION MATERIALS
PROVIDED BEFORE ENROLLING.
SHOULD YOU HAVE ANY QUESTIONS, CONTACT
YOUR BENEFITS REPRESENTATIVE AT THE
OFFICE OF EMPLOYEE HEALTH & BENEFITS
OR, IF YOU PREFER,
CONTACT H R SUPPORT DIRECTLY
AT 1-866-655-5397.
DON’T FORGET !!!
ALL FORMS MUST BE SIGNED, DATED AND
RETURNED TO:
THE STATE OF MAINE
OFFICE OF EMPLOYEE HEALTH AND
BENEFITS
114 STATE HOUSE STATION
AUGUSTA, ME 04333-0114
NO LATER THAN
THURSDAY DECEMBER 29,2005.
QUESTIONS