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Employee Benefits

Flexible Benefits - Medical Reimbursement Account

What is a Medical Reimbursement Account

A Medical Reimbursement Account allows you to set aside part of your salary each pay period on a pre-tax basis to pay for the out-of-pocket medical, dental, and vision care expenses not covered by your health benefits plan.

Eligible Expenses

The following is a partial list of expenses that are reimbursable tax-free with a Medical Flexible Reimbursement Account (FRA).

*To be eligible for reimbursement, some treatments, prescription drugs or services deemed cosmetic in nature require written proof of  medical necessity from your health care provider. For a list of eligible over-the-counter drugs, visit the FBMC Web site at www.myFBMC.com.

Note: Unused funds designated for Medical FRAs cannot be refunded to you. Please verify with your healthcare provider (prior to the end of the Open Enrollment period) that you are a suitable candidate for any surgical procedure before committing the money to your FRA.

Ineligible Expenses

FRA vs. Claiming Expenses On A Form 1040

Unless your itemized medical expenses exceed 7.5% of your adjusted gross income, you cannot claim them on your IRS Form 1040. But you can save taxes by paying for your uninsured, out-of-pocket medical expenses through a tax-free Medical Expense FRA.

Reimbursement Account Rules:

Because spending accounts offer tax advantages, the IRS places certain restrictions on these accounts.

Who is Eligible to Participate in the Medical FRA?

All employees who are eligible for the State Health Benefits Program may participate. Enrollment in the State Health Benefits Program is not required.

Expense Reimbursement

Your Medical Expense FRA may be used to reimburse eligible expenses that you, your spouse, your qualifying child or your qualifying relative incur during the plan year. See Pages 7 and 8 in the Flexible Benefits Sourcebook.

How A Reimbursement Account Works

Each year you must re-enroll in the account, even if you wish your total annual contribution for the new plan year to remain the same.

Enrollment:

For plan year minimum and maximum annual deposits to a Medical FRA, see Minimum and Maximum Contributions.

New Employee Enrollment

New employees who wish to participate in a Medical Reimbursement Account must enroll within 31 days of the date they were hired. Elections received within the 31-day election period will be effective the first of the following month. If you do not enroll during this initial eligibility period, you must wait until the next Open Enrollment or until you experience a qualifying mid-year event that would allow enrollment into a Medical Reimbursement Account.

Important: Each year you must re-enroll in the account, even if you wish your total annual contribution for the new plan year to remain the same.

For plan year minimum and maximum annual deposits to a Medical FRA, see Minimum and Maximum Contributions.

How To Enroll:

To enroll or make changes, complete the Flexible Reimbursement Account Election Form , the FRA section of the Health Benefits Enrollment Form for Active Employees, or use EmployeeDirect, the Commonwealth's health benefits enrollment system.

Changes done via Employee Direct will be confirmed in one of two ways. EmployeeDirect either approves your request right away with a link to your updated Health Benefits Profile, or it tells you and your Benefits Administrator that your request needs additional review. Before updating your Health Benefits Profile, your Benefits Administrator could ask you for supporting documents.

Fringe Benefits Management Company sends each employee a confirmation letter for elections and changes. Employees should review the letter to verify the type and amount of the election(s) and any applicable changes

Period of Coverage:

If you enroll in a Reimbursement Account during Open Enrollment, your period of coverage is the same as the plan year. If you enroll after the plan year begins, your period of coverage begins on the effective date of your coverage (which will always be the first of the month) and ends on the last day of the plan year.

If you terminate employment or become ineligible to participate in the program, your Medical FRA will end the last day of the month unless you elect to extend participation in the Medical Reimbursement Account through the end of the plan year. See your agency’s Benesfits Administrator for more information.

If you stop your participation in a Medical FRA due to a qualifying mid-year event, the account will end the last day of the month following receipt of a completed election form.

Filing A Reimbursement Request

After you enroll, you will receive reimbursement request forms to use when submitting expenses for reimbursement. You may submit a form anytime you incur reimbursable expenses during the plan year and up to three months after the end of the plan year.

For Medical Reimbursement Accounts, you will be reimbursed from your account for the total amount of the qualifying expenses claimed, up to your plan year election (as long as the expenses were incurred during your period of coverage).

Reimbursement checks for the account are generated on a daily basis and if you prefer, you may have your claim reimbursement checks sent to your bank account by direct deposit. You will have to submit a completed Direct Deposit application to the FBMC office. The Direct Deposit form can be found on this web site under Publications and Forms or obtained by calling the FBMC’s claim office at 1-800-342-8017.