FSA & SUPPLEMENTAL INSURANCE
FLEXIBLE SPENDING ACCOUNTS PROVIDED BY
The Flexible Spending Account (FSA) gives you the option to use pre-tax dollars to be reimbursed for out- of-pocket health care expenses that are not covered by a health, dental or vision insurance policy. You have the option to enroll in the Medical Expense FSA or the Dependent Care FSA. Please see the following information to determine which FSA best fits your needs. The Medical Expense FSA allows you to pay for medical, dental, vision and other “health and welfare” expense with pre-tax dollars. For example, you can use the money in this account to pay for your copays or deductible, as well as the cost for items that are not covered by your insurance, but are approved by the IRS (see IRS publications 502 and 969). You may elect to set aside up to $3,300 per year into your Medical Expense FSA. Please note, if you do not use the entire amount that you have elected to set aside within the calendar year, you can only rollover up to $500 to the next plan year. Dependent Care FSA allows you to use your pre-tax dollars to pay for qualified dependent care. A qualified dependent is under the age of 13, or a spouse/dependent who is disabled and cannot care for themselves and live with for more than 6 months of the year. You can contribute up to $5,000 per family per year ($2,500 if you are married and do not file a joint tax return) in the Dependent Care FSA. To see a full list of qualified Dependent Care FSA expenses see IRS publication 503. GROUP ACCIDENT COVERAGE PROVIDED BY UNUM Accident Insurance provides a set benefit amount based on the type of injury you have and the type of treatment you need. It covers accidents that occur off the job. And it includes a range of incidents, from common injuries to more serious events. It can help you with out-of-pocket costs that your medical plan doesn’t cover, like co-pays and deductibles. Every year, each family member who has Accident coverage can also receive $50 for getting a covered Be Well screening test. Rates Weekly Monthly Employee $2.04 $8.82 Employee + Spouse $3.69 $15.98 Employee + Child(ren) $5.09 $22.05 Family $6.74 $29.21 GROUP HOSPITAL COVERAGE PROVIDED BY UNUM Group Hospital Insurance helps covered employees and their families cope with the financial impacts of a hospitalization. You can receive benefits when you’re admitted to the hospital for a covered accident, illness or childbirth. Rates Weekly Monthly Employee $2.63 $11.39 Employee + Spouse $6.33 $27.46 Employee + Child(ren) $3.96 $17.14 Family $7.66 $33.21
16 | Foley Products Company Benefit Guide
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