Page 35 - SIH 2022 Re-Enrollment Guide
P. 35
2022
SIH Benefits Re-Enrollment
HEALTHCARE FLEXIBLE SPENDING
ACCOUNT (FSA)
The Healthcare Flexible Spending Account (FSA) is If you are currently enrolled in the FSA and make
a type of savings and spending/lexible spending a new election for 2022, you will continue use the
account that allows you to reimburse yourself with same card. New cards will be issued as the card
pretax dollars for eligible out-of-pocket healthcare expires every three years.
costs. You can use the healthcare FSA to cover
eligible healthcare expenses not covered by your Examples of Eligible Expenses
health, dental, and/or vision plans. When you do,
you don’t pay federal income taxes on the money in Some Eligible Expenses Some Expenses Not Eligible
your account. Money Can Be Set Aside for The IRS Lists These Non-Eligible
Expenses
X Deductibles X Cosmetic procedures
You can set aside $60 to $2,750* each plan year X Copayments X Your contributions for
to cover eligible expenses during the year. Your X Dental and vision care outside health or life
contributions come out of your pre-tax pay in expenses insurance
equal installments each pay period. You or your X Orthodontia not X Employer health
premiums of any kind
family members do not have to be a member of covered by a dental X Procedures or expenses
plan
any medical, dental, or vision option to enroll in the X Prescription drugs not medically necessary
healthcare FSA. Money is available as of the plan X Over-the-counter X Weight loss programs
start date with the Healthcare Flexible Spending medications (doctor’s not prescribed by a
doctor
Account. prescription required
to be eligible for
reimbursement)
* 2022 FSA plan limits have not yet been released.
X Chiropractic visits
FSAs have a “use it or lose it” policy, which means X Saline solution and
contact lens cleaners
you forfeit any amounts unused and not reimbursed X Procedures or expenses
for services received during the plan year. You may that are medically
use what you set aside for the plan year for services necessary
up to March 15th of the following year. You must ile X Doctor prescribed
weight loss programs
your claims by March 31st of the following year. The
FSA administrator is Allegiance, a Cigna Company, For more information and other tools and resources,
and provides convenient ways for you to access log on to www.AllegianceFlexAdvantage.com or
your account: call 855.999.1052.
X Debit card: You can use a debit card to pay
for eligible healthcare expenses directly from
your account
X Direct deposit: Claims processed within ive
business days of receipt
X Online viewing: Check the balance of your
account, view transactions and claims, and
see what qualiies as an eligible expense
for reimbursement 35
SIH Benefits Re-Enrollment
HEALTHCARE FLEXIBLE SPENDING
ACCOUNT (FSA)
The Healthcare Flexible Spending Account (FSA) is If you are currently enrolled in the FSA and make
a type of savings and spending/lexible spending a new election for 2022, you will continue use the
account that allows you to reimburse yourself with same card. New cards will be issued as the card
pretax dollars for eligible out-of-pocket healthcare expires every three years.
costs. You can use the healthcare FSA to cover
eligible healthcare expenses not covered by your Examples of Eligible Expenses
health, dental, and/or vision plans. When you do,
you don’t pay federal income taxes on the money in Some Eligible Expenses Some Expenses Not Eligible
your account. Money Can Be Set Aside for The IRS Lists These Non-Eligible
Expenses
X Deductibles X Cosmetic procedures
You can set aside $60 to $2,750* each plan year X Copayments X Your contributions for
to cover eligible expenses during the year. Your X Dental and vision care outside health or life
contributions come out of your pre-tax pay in expenses insurance
equal installments each pay period. You or your X Orthodontia not X Employer health
premiums of any kind
family members do not have to be a member of covered by a dental X Procedures or expenses
plan
any medical, dental, or vision option to enroll in the X Prescription drugs not medically necessary
healthcare FSA. Money is available as of the plan X Over-the-counter X Weight loss programs
start date with the Healthcare Flexible Spending medications (doctor’s not prescribed by a
doctor
Account. prescription required
to be eligible for
reimbursement)
* 2022 FSA plan limits have not yet been released.
X Chiropractic visits
FSAs have a “use it or lose it” policy, which means X Saline solution and
contact lens cleaners
you forfeit any amounts unused and not reimbursed X Procedures or expenses
for services received during the plan year. You may that are medically
use what you set aside for the plan year for services necessary
up to March 15th of the following year. You must ile X Doctor prescribed
weight loss programs
your claims by March 31st of the following year. The
FSA administrator is Allegiance, a Cigna Company, For more information and other tools and resources,
and provides convenient ways for you to access log on to www.AllegianceFlexAdvantage.com or
your account: call 855.999.1052.
X Debit card: You can use a debit card to pay
for eligible healthcare expenses directly from
your account
X Direct deposit: Claims processed within ive
business days of receipt
X Online viewing: Check the balance of your
account, view transactions and claims, and
see what qualiies as an eligible expense
for reimbursement 35
