Custom Design Benefits, Inc.
5589 Cheviot
Cincinnati, Ohio 45247
1-800-598-2929
www.customdesignbenefits.com
Southern State Community College
Flexible Spending Account Plan (FSA)
(Medical Reimbursement Account)
PLAN BENEFIT YEAR
January 1, 2013 through December 31, 2013
Southern State Community College
Flexible Spending Account
(Medical Reimbursement Account)
Eligible Medical Expense
• Deductible, co-pays, co-insurance
• Lasik Eye Surgery
• Eyeglasses / contact lenses
• Dental/Vision (member portion)
• Orthodontia
• Hearing Aids
• Rental of medical equipment
• Lab fees, x-rays
• Over-the-counter items with a prescription
Dependent Care Account
You may set aside up to $5,000
per plan year into this account.
($2,500 for married Plan members who file separate tax returns.)
Eligible Dependent Care Expenses
• Daycare expenses for IRS dependent children
• Daycare expenses for IRS dependent adults
•Preschool (not including Kindergarten tuition)
•Latch Key Programs - up to age 13
•Summer Day Camp - up to age 13
IRS Guidelines
& Terms of the FSA Plan
Use care when estimating your annual election amounts!
Mid-year election change is only permissible if
a qualified Work/Life Status change occurs,
and FSA dollars do NOT carry forward year to
year.
Active employees must submit for reimbursement within 60 days of
12/31/13.
Take Care Debit Card
The easiest way to access the funds in your FSA account is to use your
take care VISA debit card. When you pay with the card, your purchase
amount is deducted from the appropriate balance in your Flexible
Spending Account. Certain payments will require further verification, so
please hold on to your itemized bills and receipts. Custom Design
Benefits will request documentation only when it is needed.
NEW FOR 2013
Cards now have three-year expiration dates
Take Care Debit Card
Purchases that do not require receipts
Take Care Debit Card
Purchases that may require receipts
Debit Card Purchases that
always require receipts or paper claims
How Do I Get My Money If I Didn’t Use My Debit Card?
Complete a CLAIM FORM only if your debit card was not used.
Medical
Complete required information on claim form and attach an EXPLANATION
OF BENEFITS (EOB) or STATEMENT/RECEIPT detailing expenses not
covered by carrier.
Dependent Care
Complete required information on claim form and attach RECEIPT for
expenses from Dependent Care provider.
All reimbursements are mailed to the employee at their home address
Or issued by direct deposit if banking information is on hand
Mail completed form and receipts to:
Custom Design Benefits, Inc.
5589 Cheviot Road
Cincinnati, OH 45247
Fax to 513-598-2901 OR e-mail to
FlexClaims@CustomDesignBenefits.Com
CUSTOM DESIGN BENEFIT’S ACCOUNT SERVICES
• Dedicated Claims Administrator
• Daily Claims Adjudication
Allows you to keep the most updated information on your
account
• Check Issuing (Daily) or Debit Card
Debit Cards allow you to pay certain out-of-pocket expenses
on the front end but you must retain documentation for
verification of purchase. We may request some receipts.
• 24/7 Account Balance Information
Internet Services
Interactive Voice Response System
How Do I Find Out About My Flexible Spending Account & Health
Reimbursement Arrangement Balances throughout the Year?
•
Custom Design Hotline:
Local/National 866.598.2939
• Custom Design Website:
www.CustomDesignBenefits.Com
Enter your SSN# and password
(You will need to set your
password on the first visit only.)
Reimbursement Check
The Y-T-D balance summary is provided on each
reimbursement check to help manage your account
INTERNET SERVICE
FLEXIBLE SPENDING ACCOUNTS
You can view:
annual election amount for current & prior plan year
contributions made to FSA Account
claim status and reimbursement
remaining balance
last payment date & amount
You can also access claim forms online at:
CustomDesignBenefits.Com
Access Custom Design Benefits Website
www.CustomDesignBenefits.com
The screen will look exactly as the outline of the next
few slides. Click on the Member’s tab.
Once you see the options from the drop down box
you need to access Section 125-Flex
The first time you access your personal information,
you will need to establish a password
QUESTIONS???