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Flexible Spending 125 Plan
Overview
Employees may elect to make pre-tax contributions to a flexible spending account, otherwise referred to as a or 125 plan. By contributing to a flexible spending plan, participating employees may be reimbursed for medical/health-related expenses and dependent care expenses using the pre-tax dollars they have withheld from their paycheck.
The annual contribution limit to a flexible spending plan is $5,000 for medical/health-related expenses and $5,000 for dependent care expenses. The flexible spending plan is administered on a calendar year basis (i.e., January 1 to December 31). Note: Any unused funds remaining in the flexible spending plan at the end of the year are surrendered to the District.
To enroll in the flexible spending plan, complete and submit the Flexible Spending Plan Enrollment Form to the Office of Human Resources. To change your withholding amount during the year or to change your status, complete and submit the Change in Status/Change Election Form to the Office of Human Resources.
Qualifying Medical & Health-Related Expenses
The following medical and health-related expenses qualify for reimbursement through the flexible spending plan:
| Acupuncture | Alcoholism Treatment |
| Ambulance Services | Artificial Limbs |
| Braille Books | Chiropractors |
| Contact Lenses and Supplies | Contraceptives (by prescription) |
| Co-Pays | Crowns, Bridges, and Dentures |
| Crutches | Deductibles |
| Dental Cleanings | Dermatologists |
| Eye Examinations | Fillings |
| Glasses | Hearing Aids and Batteries |
| Home Health Care | Home Imp. for Medical Purposes |
| Hospital Bills | Insulin & Syringes |
| Laboratory Fees | Mammography |
| Mental Health Care | Nursing (RN/LPN) |
| OB/GYN Examinations | Orthodontia |
| Orthopedic Shoes & Braces | Physicals |
| Physical Therapy | Prescriptions |
| Psychiatric Services | Radial Keratotomy/Lasik Surgery |
| Seeing Eye Dog & Upkeep | Sterilizations & Reversals |
| Substance Abuse Treatment | Surgical Expenses |
| Telephone Equip. for the Deaf | Transportation for Medical Purposes |
| Well-Child Care | Wheelchairs |
| X-Rays |
Submitting Receipts for Reimbursement
To be reimbursed for qualifying medical and health-related expenses, employees must submit original receipts and a completed Flexible Spending Plan Reimbursement Voucher to:
Preferred Group Plans, Inc.
P.O. Box 15136
Albany, NY 12212-5136
To contact Preferred Group Plans directly with questions, call:
1-800-573-7474 or 1-518-641-0321
www.thepreferredgroup.com
Click here for more information about the Flexible Spending Plan, including a comprehensive list of the goods and services that qualify for reimbursement under the Flexible Spending Plan.
Click here for the new guidelines for over the counter drugs, as of January 1, 2011:
Flexible Spending Plan Guidelines for OTC medicines.