Page 13 - iFLY Benefit Guide 01-20

Health savings

accounts

Optum Bank | Health Savings Account
The opportunity to establish and contribute to a Examples of
Health Savings Account is available when you elect Eligible HSA Expenses
the HSA PPO medical plan option. It’s like a
personal, tax-free savings account for health care
expenses that earns interest. Any unused money  Providers (Doctors, Nurses)
rolls over from year to year.  Prescription Drugs
 Inpatient Hospital Services
In 2020, iFLY will contribute up to $500 to your  Laboratory & X-Ray
Health Savings Account. Note, you must open your KCBGA? J  Emergency Services
account with Optum Bank to receive the  Acupuncture / Chiropractic
contribution.

In addition to iFLY’s contribution, you may elect to
make contributions into your account up to IRS
maximums. IRS maximums for 2020 are:  Providers (Dentists,
 Team Member: $3,550 Orthodontists)
 Family: $7,100  Teeth Cleaning
 Catch-up (Age 55+): $1,000 BCL R? J  Dental Treatment

Orthodontia

The portion of your paycheck that you contribute to
your HSA will be taken out before you pay federal
income taxes, Social Security taxes and most state
taxes (excluding state taxes in AL, CA and NJ). Any  Providers (Optometrists,
contributions you make can be increased or Ophthalmologists)
decreased over the course of the year. The money  Exams
in your HSA is yours to save and spend on eligible  Glasses
health care expenses whenever you need it, TGQGML  Contact Lenses
whether in this plan year or in future plan years.  Lasik Surgery

Managing Your HSA
Go to www.optumbank.com or call (866)
234-8913.  COBRA
 Long-Term Care
NPCKGSKQ  Medicare

Examples of
Ineligible HSA Expenses

Ineligible HSA expenses include expenses that are
Educational Video not medical or health-related as well as cosmetic
Health Savings Accounts
http://video.burnhambenefits.com/hdhp

Team Member Benefits 13