Flexible Spending Account - Unreimbursed Medical Plan
PO Box 2349
Conway, AR 72033
The Unreimbursed Medical Account is a pre-tax benefit reimbursing employees for out of pocket medical expenses. Expenses that are deemed to be medically necessary and that are not reimbursed by insurance may be deducted through a Section 125 Cafeteria Plan. The reimbursement amount is based solely on the employee’s contributions to the spending account.
All full-time employees are eligible to elect the Unreimbursed Medical/Flexible Spending Account.
New Hires: All full-time employees are eligible to apply for coverage upon hire.
Qualifying Family Status Changes: Changes to coverage may be made within 30 days of a qualifying family status change. Examples of a qualifying family status change are birth or adoption of a child, marriage and divorce.
Annual Open Enrollment: Each fall there is an annual open enrollment period in which employee can add, cancel or change enrollment.
You must re-enroll in the plan each year.
Employee decides the amount of his/her per pay period contribution. Beginning 2013 the annual maximum contribution limit is $2,500.
IT IS IMPORTANT THAT EXPENSES ARE PROPERLY ESTIMATED FOR THE UNREIMBURSED MEDICAL EXPENSES ACCOUNT BECAUSE UNUSED AMOUNTS AT THE END OF EACH PLAN YEAR/GRACE PERIOD WILL BE FORFEITED.
- Tax-free reimbursement for out of pocket expenses deemed medically necessary. Some of the types of expenses that qualify for tax-free reimbursement include medical supplies, contact lenses, eye exams, eyeglasses, orthodontic fees, physician fees, some over the counter drugs.
- Reimbursement for co-pays and deductibles for service. NOTE: Premium payments cannot be reimbursed.
- Employees do not have to wait for contributions to accumulate before requesting reimbursement.
- Employees have 90 days after the end of the Plan Year to submit vouchers to clear the account.
A debit card is available for use for eligible medical expenses. If you are unable to use the debit card for certain expenses, an expense voucher may be used to process your request for reimbursement. You should retain records for your file in case of audit.
For questions about the benefits offered through this plan, contact your Benefits Coordinator or contact FlexCo, Inc. directly.
Barry Roe, Patrick Hickman
Unreimbursed Medical Expense Voucher
Unreimbursed Medical Debit Care Request Form
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