MANAGING YOUR BENEFITS JUST GOT EASIER

Expenses incurred for a daycare center or private sitter for an eligible dependent may be covered by your Dependent Care Spending Account within a Cafeteria Plan.

Rules of Eligibility:

• Claimed by the employee as a dependent for federal tax purposes for the tax year the employee is electing
• Under age 13: after school care only, or summer full-time care
• Infant to 4K Kindergarten: full-time care
• Age 5K to Kindergarten: after school care only
• Requires full-time care because of physical or mental incapacity (for example, a disabled spouse or parent)
• Eligible care only includes the cost of services for the individual’s well-being and safety

Ineligible Expenses:

• Eligible care does not include the cost of transportation, clothing, entertainment, or food, unless such items are incidental and cannot be separated from the cost of care provided
• Schooling in 5K or higher
• Expenses for when you are off work due to illness
• Payments made to your child under the age of 19
• Payments to yourself or your spouse’s dependent
• Expenses to send your child to overnight camp

Dependent Care Receipts Must Include:

• Care provider’s tax identification number or social security number
• Child(ren) name, and date of birth (or age)
• Amount of expense and date of service, not date paid

IMPORTANT: All claims must be filed with your insurance carrier first. To claim your expenses, an Explanation of Benefits from your insurance carrier is preferred and may be required. The amount you pay your provider at the time of service is not necessarily the amount you will ultimately owe. Your insurance carrier will reduce your out-of-pocket cost through network discounts and other predetermined agreements, and a credit will appear on your account.

All URM receipts must include the following information:

• A medical provider’s name & address
• Date of service (not date paid)
• Type of service/expense and cost of expense(s)
• All documentation must originate from a third-party provider.

Medical expenses must include the patient’s name.

Prescription drugs must include the name of the drug and Rx number on the receipt, along with the information indicated above.

NOTE: Statements with a Balance Forward or Previous Balance that does not include the date and type of service are NOT REIMBURSABLE.

If you are claiming expenses under your employer’s HRA, you must submit a copy of your Explanation of Benefits (EOB), which is provided by your insurance carrier, and complete the claim form provided by your employer.

If your plan allows for reimbursement of dental or vision, your receipts must be submitted in the form of an EOB, or contain the following information:

• Date of service (not date paid)
• Medical provider’s name and address
• Type of service
• Cost of service after insurance (if applicable)

You can deduct the cost of medical procedures done in another country as long as it is a legal operation and not “unnecessary cosmetic surgery”. This is the same requirement for procedures done in the U.S. IRS Publication 502 will give you more information and an extensive list of covered medical expenses.

In order to be reimbursed, you must provide a third party receipt listing the date the service, type of service, patients name and your cost. If the receipt is in a foreign language, it must be translated by a third party and notarized.

In general, you cannot be reimbursed for prescription drugs purchased or shipped from another country. An exception would the cost of a prescribed drug the Food and Drug Administration announces can be legally imported. You can include the cost of a drug you purchase and consume in another country, if the drug is legal in both the other country and the United States. The Internal Revenue Service has no official exchange rate. Normally, you can use the exchange rate prevailing (i.e., the spot rate) when you receive, pay or accrue the item.

Medical expenses incurred to help you lose weight may be eligible for reimbursement if your treatment is for a specific disease diagnosed by a physician (such as obesity, hypertension or heart disease). This includes fees you pay for membership in a weight reduction group, as well as fees for attendance at periodic meetings.

You cannot be reimbursed for membership dues in a gym, health club, or spa, but you can include separate fees charged for the weight loss activities. You cannot include the cost of diet food, supplements or beverages, because they are substitutes for what is normally consumed to satisfy nutritional needs.

There are two ways to submit weight loss medical expenses for approval. Upon SABC’s approval, expenses can be submitted.

1. Ask your physician to complete a “Medical Necessity Confirmation” form.
2. Obtain a letter from your physician stating what disease the weight loss program is treating, the prescribed treatment, and the treatment period. This letter will have to be updated each plan year, or at the end of the prescribed period. The letter must include:
   • Patient name
   • Physician name and contact information
   • Employer name and contact information