Page 9 - Benefits Summary/New Hire Enrollment Guide

Flexible Spending

Accounts (FSA)

Ann Champagne Stephanie Karl

Northern Human Services offers regular full and part-time (20 hours or more per week) employees the
opportunity to participate in a Flexible Spending Account (FSA) program through our carrier csONE Benefit
Solutions.

The FSA program allows employees to have pre-tax dollars deducted from their wages to pay for eligible out-
of-pocket expenses. Employees are eligible for the FSA program on the first of the month following 60 days of
employment. The pre-tax contributions made to the FSA can be used to pay for non-reimbursed health care
expenses and/or dependent care expenses during the plan year. The FSA program reduces your taxable
income, allowing you to keep more of the money you earn.

• Health Reimbursement Account expenses are limited to $2,750 per plan year.
• Dependent Care Reimbursement Account expenses are limited to $5,000 per plan year.

Participation in the Health Care and/or Dependent Care FSA is optional and determined on an annual basis for
the plan year. You must re-elect for each plan year. You determine how much to contribute to the account,
up to a specified maximum, based on your anticipated expenses during the plan year. Contributions are
directed to the FSA through payroll deduction on a pre-tax basis. This tax-free money is then available to you
for reimbursement of qualified out-of-pocket expenses.

The FSA program includes a $500 rollover provision that will allow participants to carry over up to $500 of
their unused Health FSA balance remaining at the end of each plan year. Participants will have the 90-day
run-off period (July 1, 2020 – September 28, 2020) to submit claims from the prior year and then the rollover
would kick in for funds up to $500. Employees can still elect the full allowable Health FSA Benefit amount
even if they carry over the maximum amount of $500 from the prior year.

Please Note: Effective January 1, 2020, the CARES stimulus act mandates that Over-the-Counter medications
and supplies are once again eligible qualified expenses.

Please contact your local Office Manager for more information on the Flexible Spending Account program and
to obtain enrollment and reimbursement forms and worksheets with examples of reimbursable and non-
reimbursable expenses.

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