UC COM Dual Comp Benefits Book

HEALTH AND DEPENDENT CARE SAVINGS/SPENDING PLANS HEALTH SAVINGS ACCOUNT (HSA)

ELIGIBLE ONLY WHEN ENROLLED IN HSA MEDICAL PLAN 65%+ FTE FACULTY 75%+ FTE STAFF

ELIGIBILITY

 Employees may contribute pre-tax dollars to pay eligible health care expenses that are not covered by medical, dental or vision plans  HSA balance carries over year to year  UC contribution is based on total annual base pay (UC + UCP)  Maximum annual combined employer and employee contribution: • $4,300 individual • $8,550 family • $1,000 over age 55 catch up contribution

PLAN INFORMATION

EMPLOYEE CONTRIBUTION

PLAN ADMINISTRATOR

FLEXIBLE SPENDING ACCOUNTS (FSA): HEALTH CARE & DEPENDENT CARE

ELIGIBLE FOR HEALTH CARE FSA ONLY WHEN ENROLLED IN PPO MEDICAL PLAN OR IF MEDICAL COVERAGE IS WAIVED. 65%+ FTE FACULTY 75%+ FTE STAFF  Employees may contribute pre-tax dollars to pay eligible dependent day care expenses and/or health care expenses that are not covered by medical, dental or vision plans  Annual contribution must be applied to expenses incurred in same plan year  Unused balances may be claimed until 02/28 of the following plan year, after which they are forfeited Dependent Care: employees may contribute up to $5,000 per calendar year Health Care: employees may contribute up to $3,200 per calendar year

ELIGIBILITY

PLAN INFORMATION

FSA EMPLOYEE CONTRIBUTION

PLAN ADMINISTRATOR

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