Acom Benefit Guide - Class 1 - Officers, Directors

HSA Coverage

Your eligibilty

In order to open and fund an HSA, you must meet the

following requirements: • You are enrolled in Acoms High Deductible Plan (HDHP) • Are not covered under another medical plan such as Medicare, Tricare or a spouse’s medical plan (not an HDHP) which provides similar coverage; and • Cannot be claimed as a dependent on another person’s insurance policy or tax return.

Qualified Health Care Expenses

Each time you have a medical, dental or vision expense you decide if you want to pay with money from your HSA. “Qualified Medical Expenses” are determined by the US Treasury, 213(d) expenses, and detailed in IRS Publication 502. Some examples include but are not limited to:

Expenses that apply toward your deductible

2022 IRS Calendar Year Contribution Limit

• • • • • •

Prescription expenses Contact lens fitting

Acom is contributing $1,200 annually directly into your HSA

Orthodontia Acupuncture Artificial teeth Eye glasses

The amount you may contribute to your HSA is based on your HDHP medical plan’s tier. 2022 If you cover just yourself on the plan: $3,650 If you cover yourself and a spouse or dependents: $7,300 Age 55+ Catch-Up: $1,000

Whose Medical Expenses Can You Use Your HSA Funds on?

When You Can Begin Contributing

Generally your:

You may begin funding your HSA when your medical HDHP

Legally married spouse. Domestic partners are not covered under the tax code. Permanently and totally disabled dependent of any age. Dependent under the age of 19 at the end of calendar year or a full-time student under the age of 24 at the end of the calendar year who also: Lived with you more than 1/2 the calendar year, and Didn’t provide over 1/2 his/her own support in the calendar year, and Didn’t file a joint tax return, other than to claim a refund

benefits begin.

You are able to contribute as little or as much (up to the IRS limit) as you wish out of each paycheck and this election may be changed at any time throughout the year.

When You Cannot Contribute

If you terminate HDHP medical plan coverage (or employment) with Acom, you may no longer contribute to your HSA through Acom payroll deduction. You own the HSA so your balance can be carried over year after year and the funds you contributed always belong to you.

Benefits of an HSA

Tax Savings! An HSA provides triple tax savings: (1) tax deductions when you contribute to your account (2) tax-free investment earnings (3) tax-free withdrawals for qualified medical expenses

Qualifying relative. See IRS Publication 502 for more information.

7 Acom Integrated Solutions 2022 Enrollment Guide

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