Benefits Handbook

In general, the Plan will reimburse:

For examples of IRC Section 213 qualified medical expenses, see IRS Publication 502, which is available at www.irs.gov or by calling the IRS at +1 800 829 3676. Note that certain items listed in Publication 502 may not qualify for Health Care Flexible Spending Account reimbursement, such as premiums for dental or vision insurance. You may also contact the Claims Administrator, for information about reimbursable qualified medical expenses.

According to the IRS, a qualifying family member includes any person who qualifies for tax-free health plan benefits, including any of the following individuals:

You can be reimbursed for eligible expenses for you, your spouse or your qualifying family members.

Unless your domestic partner or his or her children qualify for tax-free health plan benefits (as described above), the federal government does not permit you to use health care flexible spending accounts for eligible expenses incurred by your domestic partner or his or her children.

There are several ways for you to be reimbursed for eligible Health Care Flexible Spending Account expenses:

Claims Submission by Mail:

The Prepaid MasterCard® is a special-purpose MasterCard® that gives you a way to pay for eligible expenses without needing to submit claims. The Prepaid MasterCard® lets you electronically access the amount you elected to contribute to your Health Care Flexible Spending Account at qualifying providers.

The Spending Account Service Center will provide two (2) Prepaid MasterCards®, which will be loaded with your Health Care Flexible Spending Account election. Additional or replacement cards are available for a $10.00 fee (come in packages of 2 cards) charged directly to your account. If you participate in more than one account, the fee would be charged first to your Health Care Flexible Spending Account, then your Dependent Care Flexible Spending Account.

The Prepaid MasterCard® works like a debit card, with your account balance stored on it. When you use the Prepaid MasterCard®, the amount of the eligible expenses will be deducted automatically from your Health Care Flexible Spending Account and payment will be electronically transferred to the provider/merchant. There are no monthly bills and no interest. The total amount you elected for the plan year is available for reimbursement at the start of the year, regardless of your contributions at the time of reimbursement.

Reimbursements are issued by the Claims Administrator. You can submit your eligible expenses for reimbursement at any time after you incur the expense, provided that you submit your claim for reimbursement before the claims submission deadline of March 31of the following plan year.

Forms can be found on the Claims Administrator's website or be requested from the Claims Administrator by calling +1 866 324 4087.

For eligible expenses that are not reimbursed by using the Prepaid MasterCard®, such as eligible expenses at a provider who is not a qualifying provider, you must submit a claim for reimbursement. The Claims Administrator will reimburse eligible expenses directly to you from your Health Care Flexible Spending Account. The Claims Administrator will do one of the following:

Your first reimbursement may be paid by check while the Claims Administrator authenticates your bank information for direct deposit.

Reimbursements are processed within three to four business days of the Claims Administrator's receipt of the completed claim form and required documentation.

No. There is no minimum amount of expenses when submitting a claim for reimbursement.

The total amount elected for the plan year and any carryover amount is available for reimbursement at the start of the year, regardless of your contributions at the time of reimbursement. You can be reimbursed up to your account balance, which is the total amount you elected for the plan year minus the amount you have already been reimbursed.

Eligible expenses are reimbursed from your account balance, which is the total amount you elected for the plan year minus the amount you have already been reimbursed.

Yes, but you must submit documentation confirming that services were rendered including dates of service, services rendered and your cost for these services (such as an itemized statement from your provider or an Explanation of Benefits from the insurer) before you can be reimbursed for eligible expenses.

Yes, but you must submit documentation confirming that services were rendered including dates of service, services rendered and your cost for these services (such as an itemized statement from your provider or an Explanation of Benefits from the insurer) before you can be reimbursed for eligible expenses. When you submit your claim, you may opt to have your payment sent to "Someone Else" and submit your providers name, address, the patient's full name and your account number at the provider's office during the transaction. Once your claim is approved, the reimbursement process will send a check from your Health Care Flexible Spending Account directly to your provider's office to pay for your eligible item or service.

No, expenses incurred before your participation begins cannot be reimbursed.

You can submit your expenses for reimbursement as often as you would like, provided that you submit your claim for reimbursement before the claims submission deadline of March 31 of the following plan year.

Yes, all purchases with the Prepaid MasterCard® are required to be "substantiated," or verified as an eligible health care expense. There are some ways in which your eligible health care expense(s) are automatically substantiated in compliance with IRS regulations. These include co-pay matching substantiation, claims auto-substantiation, and IIAS-Certified Merchant pharmacies.

If a Prepaid MasterCard® purchase cannot be verified by one of the automatic substantiation methods, the IRS requires that you submit itemized receipts to verify that the purchase was eligible for reimbursement under the Health FSA.

All purchases with the Prepaid MasterCard® are applied to the plan year in which the Prepaid MasterCard® was swiped at the merchant. The debit card does not receive information to validate the date of service in which your claim was incurred. In order to reverse your carryover funds and transfer your expense to the prior plan year, a request must be made to the Spending Account Service Center along with adequate substantiation to show the correct plan year to which the card swipe should be applied. The Spending Account Service Center will not automatically apply any transaction to a previous plan year without consent from the accountholder to do so.

You will receive a Receipt Request letter from the Claims Administrator, the Spending Account Service Center, requesting you to submit an itemized receipt or Explanation of Benefits (EOB) for each unsubstantiated expense. Documentation must include the merchant or provider name, service received or item purchased, date of service or date of purchase, description of the expense and the amount of the expense.

You will have 30 days from the date of the letter to submit your documentation to the Spending Account Service Center. If you fail to submit documentation within the 30 day period, you will be sent a second Receipt Request letter from the Spending Account Service Center. You will then have 60 days to submit your documentation to the Spending Account Service Center.

If you submit documentation to substantiate the expense(s) and the Spending Account Service Center requires more information to make an eligibility determination, you will be sent a Request for More Information (RMI) letter from the Spending Account Service Center. You will then have an additional 30 days to submit your additional documentation to the Spending Account Service Center.

If you submit documentation to substantiate the expense(s) and the Spending Account Service Center determines the expense(s) is ineligible, you will be sent an Ineligible Notice letter from the Spending Account Service Center. You will then have 30 days to submit a repayment check to the Spending Account Service Center. If you fail to repay the expense to the Plan, the expense will be reported to the Internal Revenue Service as taxable income to you.

If documentation is not available, you may send a check payable to the Spending Account Service Center for the expense amount. These monies will be applied to your Health FSA for future reimbursement of eligible expenses. Alternatively, if you have a different eligible expense that was paid out of pocket, you may submit an itemized receipt for it to offset the payment for the expense for which you do not have the necessary documentation.

Your Prepaid MasterCard® will be temporarily suspended (i.e., cannot be used for further purchases) until the required documentation or repayment check is received and the claim(s) have been verified by the Spending Account Service Center.

Once your Prepaid MasterCard® has been suspended, you won't be able to use your Prepaid MasterCard® for purchases. However, if you need to purchase items during this suspension period, you can still submit a claim reimbursement request form, either online at the Spending Account Service Center, on the mobile app, by fax, by email at mmc@marshmma.com or by mail.

If you fail to substantiate an expense or otherwise repay the expense to the Plan, the expense will be reported to the Internal Revenue Service as taxable income to you.

If your Prepaid MasterCard® has been suspended, and you then send in the necessary documentation to prove the expense's eligibility and it is deemed to be an eligible expense, your Prepaid MasterCard® will be reactivated and available for use.

If your Prepaid MasterCard® has been suspended, and you then send in a repayment check for the ineligible expense(s), your Prepaid MasterCard® will be reactivated and available for use.

Yes, the carryover feature for the 2024 plan year will allow a maximum balance of $610 to be carried over from your Health Care Flexible Spending Account for use in the 2025 plan year.

Any claims for eligible expenses incurred in 2023 that are submitted between January 1, 2024 and March 31, 2024 will be reimbursed from your 2023 balance. After March 31, 2024, any 2023 balance over $570 will be forfeited. Up to $570 of your 2023 account balance will be available on January 1, 2024 for eligible expenses incurred in 2024.

Note: The carryover amount for the 2024 plan year has increased to $610 (2023 plan year maximum carryover amount is $570). If you contribute to a Health Care FSA in 2024 and have a balance as of December 31, 2024, the maximum amount carried over into 2025 will be $610. Any amount over $610 that is not used for eligible expenses incurred during 2024 will be forfeited. You may contribute up to the maximum amount ($3,050 in 2024) each year, regardless of whether any amount is carried over from the prior year.

An example of plan year 2024 carryover (maximum amount carried over into 2025 is $610):

Based on the current plan terms and applicable law, for the 2024 plan year (and subsequent plan years), after March 31, 2025, any 2024 balance over $610 will be forfeited at that time. Up to $610 of your 2024 account balance will be available on January 1, 2025 for eligible expenses incurred in 2025.

No. The 2024 carryover (up to a maximum of $610) does not affect the maximum amount of contributions that you may contribute to your Health FSA. You may contribute up to the maximum amount each year, regardless of whether any amount is carried over from the prior year. The maximum contribution amount for 2024 is $3,050.

The 2023 carryover funds are subject to the plan terms of the Health FSA applicable to you as a result of your medical plan and the Spending Account Service Center Health Savings Account election for 2024, as shown in the chart below:

No. If you do not elect a Health FSA in the following year, a Health FSA will be established for you for the carryover funds.

The type of Health FSA established for you depends solely on your 2024 medical coverage election, as shown in the chart below:

You have until December 31 of the plan year into which funds are carried over to incur eligible expenses. The deadline to submit claims is March 31 of the following year.

For example, $570* is carried over from 2023 to your 2024 Health FSA. You have all of 2024 to incur expenses and submit claims against any 2024 election amount plus the 2023 carryover funds. You then have until March 31, 2025 to submit claims for reimbursement for claims incurred in 2024.

No. Your eligibility to contribute to a Health Savings Account is not impacted by the carryover feature, and you can contribute to a Health Savings Account starting on January 1, as long as you meet the eligibility requirements. Please note that if you are covered by a Health Care Flexible Spending Account, you are not eligible to contribute to a Health Savings Account.

If your participation ends during the year, you will not be reimbursed for expenses incurred after the date your participation ends (for example, after your employment ends, unless you continue participation through COBRA). You will, however, have until March 31 of the following plan year to submit for reimbursement eligible expenses you incurred during the plan year while you were participating.

If you were participating in the Health FSA solely from the prior plan year's carryover funds, you are not eligible to continue participation through COBRA. You will, however, have until March 31 of the following plan year to submit reimbursement for eligible expenses you incurred during the plan year while you were participating.

Your before-tax contributions cease. (In some circumstances, COBRA participation may be available.)

Upon return to work, your before-tax contributions will resume. The amount of your before-tax contributions will be recalculated for the remainder of the year to "catch-up" for your missed contributions while on leave. The balance of your annual election will be divided by your remaining pay dates, spreading the balance over the remaining pay periods through the end of the year. This will increase your per pay period contribution upon return from your authorized unpaid leave.

For example, suppose your annual election to the Health Care Flexible Spending Account is $1,200 and you are on an authorized unpaid leave from July 1 through November 1. You will have contributed $600 before you began leave and your contributions will stop while you are on leave. When you return to work, the remaining $600 of your annual election will be spread out over the November and December pay periods. You can submit claims for reimbursement for any eligible expenses you incur while on an authorized unpaid leave.

There are special rules, procedures and deadlines that apply to appeals of benefit determinations and denied claims and you have special legal rights under ERISA. Please refer to the Administrative Information section for a description of the appeal process.

Go to www.irs.gov and enter "502" in the "Search" box for more information about IRC Section 213 qualified medical expenses. Note that certain items listed in Publication 502 may not qualify for Health Care Flexible Spending Account reimbursement, such as premiums for dental or vision insurance (see "Examples of Eligible Expenses" and "Examples of Ineligible Expenses" for more information).

You may also contact the Claims Administrator for information about reimbursable qualified medical expenses.