Page 14 - Apricity Benefits Guide
P. 14
2020
Apricity Benefits Overview
FLEXIBLE SPENDING
ACCOUNTS
Health Care FSA
A Health Care FSA provides you with the ability to save money
on a pre-tax basis for IRS-allowed health expenses that are not
covered by your health care plan. Some examples of eligible
expenses include orthodontia, LASIK surgery, eyeglasses, contact
lenses and supplies, deductibles, copays, coinsurance, and
prescription drug costs. You may elect to contribute between
$250 and $2,750 to a Health Care FSA each calendar year.
Enrollees in an HSA are not allowed to enroll in the traditional
Health Care FSA.
Plan carefully! Up to $500 of unused Health Care FSA funds
can be rolled over into the 2021 FSA plan year. However, any
amount in excess of $500 will be forfeited. You will have until
March 31, 2021, to submit claims for eligible expenses incurred
during the 2020 plan year with the exception of the $500 rollover
provision.
Limited Purpose FSA
A Limited Purpose Health FSA (referred to as a limited purpose
FSA) is much like a traditional Health Care FSA. However, under
a limited purpose FSA, eligible expenses are limited to qualifying
dental and vision expenses for you, your spouse, and your
eligible dependents. Enrollees in the HSA may also enroll in the
Limited Purpose FSA with a contribution between $250 and
$2,750.
Table of Contents Your Quick Guide to Savings and Group Auto and Home Insurance .33
About Your Beneits Program. . . . . . .2 Spending Accounts .............16 Group Legal Services ............33
Beneits Basics ...................3 Dental Beneits .................18 Employee Assistance Program ....34
Medical/Prescription Drugs Beneits . 6 Dental Plan Summary ............20 Medicare Part D Creditable
Comparing Medical Plan Options ..7 Vision Beneits ..................21 Coverage Notice ...............35
First Stop Health ................11 Voluntary Disability Insurance .....22 Premium Assistance Under Medicaid
Medical Plan Summary ..........12 Life and AD&D Insurance ........25 and the Children’s Health Insurance
Program (CHIP) .................42
Pharmacy Plan Summary .........13 Voluntary Accident Insurance ....29 Contact Information .............46 14
Flexible Spending Accounts ......14 Voluntary Critical Illness Insurance . 31
Apricity Benefits Overview
FLEXIBLE SPENDING
ACCOUNTS
Health Care FSA
A Health Care FSA provides you with the ability to save money
on a pre-tax basis for IRS-allowed health expenses that are not
covered by your health care plan. Some examples of eligible
expenses include orthodontia, LASIK surgery, eyeglasses, contact
lenses and supplies, deductibles, copays, coinsurance, and
prescription drug costs. You may elect to contribute between
$250 and $2,750 to a Health Care FSA each calendar year.
Enrollees in an HSA are not allowed to enroll in the traditional
Health Care FSA.
Plan carefully! Up to $500 of unused Health Care FSA funds
can be rolled over into the 2021 FSA plan year. However, any
amount in excess of $500 will be forfeited. You will have until
March 31, 2021, to submit claims for eligible expenses incurred
during the 2020 plan year with the exception of the $500 rollover
provision.
Limited Purpose FSA
A Limited Purpose Health FSA (referred to as a limited purpose
FSA) is much like a traditional Health Care FSA. However, under
a limited purpose FSA, eligible expenses are limited to qualifying
dental and vision expenses for you, your spouse, and your
eligible dependents. Enrollees in the HSA may also enroll in the
Limited Purpose FSA with a contribution between $250 and
$2,750.
Table of Contents Your Quick Guide to Savings and Group Auto and Home Insurance .33
About Your Beneits Program. . . . . . .2 Spending Accounts .............16 Group Legal Services ............33
Beneits Basics ...................3 Dental Beneits .................18 Employee Assistance Program ....34
Medical/Prescription Drugs Beneits . 6 Dental Plan Summary ............20 Medicare Part D Creditable
Comparing Medical Plan Options ..7 Vision Beneits ..................21 Coverage Notice ...............35
First Stop Health ................11 Voluntary Disability Insurance .....22 Premium Assistance Under Medicaid
Medical Plan Summary ..........12 Life and AD&D Insurance ........25 and the Children’s Health Insurance
Program (CHIP) .................42
Pharmacy Plan Summary .........13 Voluntary Accident Insurance ....29 Contact Information .............46 14
Flexible Spending Accounts ......14 Voluntary Critical Illness Insurance . 31
