Flexible Spending Accounts
Flexible Spending Accounts
Flexible Spending Accounts, (FSAs) offer a convenient and easy way to save money for eligible
medical and dependent care expenses. If you're interested, you can participate in either or both
of these plans:
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Medical Reimbursement Account reimburses out-of-pocket health care costs not
covered by any other plan.
Dependent Care Account reimburses the cost of dependent care incurred by such
Participant for household services or for the care of qualifying individuals, but only if the
expenses are necessary for the gainful employment of the Participant.
Employees who enroll in an FSA must re-enroll in the plan every open enrollment period if
they wish to continue participation during the next plan year. Eligible employees will be
able to enroll in the FSA on the first day of the month following date of hire, provided an
application is submitted within 30 days of hire. For details about the plans, see the FSA plan
contract at the Office of Group Insurance web page.
FSA Plan Provisions
When you enroll, you elect how much you want to contribute to each FSA for the coming plan
year. Your contributions are deducted from your paychecks on a pre-tax basis and go directly
into the elected FSA account(s) under your name. When you incur an eligible expense, first you
pay the bill out of your own pocket then you submit a claim for reimbursement. All medical
Reimbursement Account claims must be accompanied by the Explanation of Benefits your
insurance carriers send you when a claim is processed.
Current contribution limits are as follows:
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
Medical Reimbursement Account, maximum of $2,500 per plan year.
Dependent Care Account, maximum of $5,000 per plan year.
You will have until September 13 to incur claims for the previous July 1 to June 30 plan year. In
order to be reimbursed, SHDR must receive all claims for the previous plan year by the close of
business on October 31.
It's important to keep in mind that the IRS states you must forfeit any money left in your FSA
account after the filing deadline. Avoid forfeiting money by realistically and conservatively
choosing how much you're likely to need in the coming year.
FSA Reimbursement Forms
To file for reimbursement, complete the FSA Reimbursement form found under Health Benefit
Forms, Completed forms can be faxed to (252) 293-9048 or (252) 293-9049 or mailed to:
Stanley, Hunt, DuPree & Rhine, Inc.
Post Office Box 6400
Greeneville, SC 29606
(864)-527-0600
Website: www.shdr.com