«Summary Plan Description SAS Institute Inc. Premium Conversion and Flexible Spending Account Plan Full-Time and Part-Time Employees of SAS and ...»
The failure to timely elect continuation coverage or to make each contribution in full on a timely basis will automatically result in the termination of COBRA coverage under the Health Care FSA Plan. The Company does not assume any responsibility for the non-delivery or untimely delivery of any COBRA election form or contribution.
You will have to pay the entire cost of your continuation coverage on an after-tax basis. The cost of your continuation coverage will not exceed 102% of the applicable premium for the period of continuation coverage. The cost of coverage in your case will be specified in the COBRA election materials.
The first contribution after electing continuation coverage will be due 45 days after you make your election and your contributions must be made for the entire period from the date of the Qualifying Event to the date of your first payment. Subsequent contributions are due the first day of each month. The Employer will not provide billing statements for subsequent contributions. Your coverage will automatically be cancelled and the balance of your Health Care FSA forfeited if the entire amount of each contribution is not received within 30 days of its due date.
Keep Your Plan Informed of Address Changes In order to protect your family’s rights, you should keep SAS informed of any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to SAS or the Plan Administrator.
If You Have Questions Questions concerning the Plan or your COBRA continuation coverage rights should be addressed to the SAS Benefits Department at the address listed above.
HIPAA PRIVACYA federal law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), requires that health plans protect the confidentiality of your private health information.
The Plan will not use or further disclose information that is protected by HIPAA (“protected health information”) without your authorization except as necessary for treatment, payment, health plan operations and plan administration, or as permitted or required by law. By law, the Plan requires all of its business associates to also observe the HIPAA privacy rule. In particular, the Plan will not, without authorization, use or disclose protected health information for employment-related actions and decisions or in connection with any other benefit or employee benefit plan of SAS. The Plan may disclose your protected health information to the Employer in certain limited circumstances.
Under HIPAA, you have certain rights with respect to your protected health information, including certain rights to see and copy the information, receive an accounting of certain disclosures of the information and, under certain circumstances, amend the information. You also have the right to file a complaint with the Plan or with the Secretary of the U.S. Department of Health and Human Services if you believe your rights under HIPAA have been violated.
The Plan maintains a privacy notice (the “Privacy Notice”) that contains a more detailed description of your rights under the HIPAA privacy rule. For a copy of the Privacy Notice, please contact Michelle Jones Manager, Benefits (the “Privacy Official”). If you have questions about the privacy of your health information or wish to file a complaint under HIPAA, please contact the Privacy Official.
DEPENDENT CARE FLEXIBLE SPENDING ACCOUNTThe Dependent Care Flexible Spending Account (or “Dependent Care FSA”) may be used to pay, on a pre-tax basis, those qualifying dependent care expenses which are necessary because you (and your spouse, if married) work.
If you are married, you can use the Dependent Care Flexible Spending Account only if both you and your spouse are employed, unless your spouse is disabled or is a full-time student for at least five months in the calendar year. Under the Dependent Care Flexible Spending Account, your “spouse” is the person to whom you are legally married, as recognized under state law and the Internal Revenue Code. A domestic partner is not considered your “spouse” for purposes of the Dependent Care Flexible Spending Account.
MAXIMUM ANNUAL CONTRIBUTION AND SPECIAL LIMITSUnlike the Health Care FSA, your total annual contribution under the Dependent Care FSA is not available for reimbursement at any time during the Plan Year. You are only eligible to be reimbursed on a particular date for what you have actually contributed to the Dependent Care FSA as of that date.
Your dependent care reimbursement for a taxable year (and the amount you contribute to your
Dependent Care FSA) may not exceed the least of the following limits:
(a) $5,000 per family (if you are single; or, you are married and filing a joint return or filing as head of household), or $2,500 (if married filing separate tax return).
(b) Your taxable compensation (after all compensation reduction arrangements), or
For purposes of (c) above, if your spouse is a full-time student at an education institution or is physically or mentally incapable of caring for himself or herself, your spouse will be considered to have earned income of $3,000 per year or $6,000 per year if there are two or more dependents.
As discussed below, Dependent Care FSA maximums are reduced by the value or cost of Employer provided day care.
QUALIFYING DEPENDENT CARE EXPENSESReimbursement is available for “qualifying dependent care expenses” as described in Section 129 of the Internal Revenue Code. Generally, an expense must meet all of the following conditions for it to
be reimbursable under the Dependent Care FSA:
The expense must be incurred for a “Qualifying Individual.” A Qualifying Individual is defined as your qualifying child under age 13; or your spouse or other dependent who is physically or mentally incapable of caring for himself or herself. Note: There is a special rule for children of divorced parents. The child is generally a Qualifying Individual of the “custodial parent” as defined in Internal Revenue Code Section 152(e).
The expense must be incurred for the care of a Qualifying Individual (as described above), or for related household services, and it must be incurred to enable you (and your spouse, if applicable) to be gainfully employed.
If the expense is incurred for services outside your household and such expense is incurred for the care of a Qualifying Individual who is age 13 or older, the Qualifying Individual must regularly spend at least 8 hours per day in your home.
If the expense is incurred for services provided by a dependent care center (i.e., a facility that provides care for more than 6 individuals not residing at the facility), the center must comply with all applicable state and local laws and regulations.
The expense must not be paid or payable to a child of yours who is under age 19 at the end of the year in which the expense is incurred, to your spouse; or to an individual for whom you or your spouse is entitled to a personal tax exemption as a dependent.
Examples of expenses that cannot be reimbursed through the Dependent Care FSA include:
Food, clothing, or entertainment for a spouse or dependent.
Expenses for overnight camps or specialty camps.
Nursing home expenses, unless the spouse or dependent spends at least eight hours a day in your household.
Tuition expenses for kindergarten.
Expenses for education for qualified spouse or dependents.
Transportation to get the spouse or dependent to and from a daycare outside of you home.
Services provided by your spouse, a dependent, or by your child who is under age 19.
You must notify the Administrator if you have reason to believe that any expense for which you have obtained reimbursement is not an eligible expense under the Dependent Care FSA.
QUALIFIED DEPENDENT CARE PROVIDER
The following are common categories of dependent care providers:
A licensed child care or adult day care center.
Child care inside your home or someone else’s home.
Dependent adult day care inside your home or someone else’s home.
Specialty day camps for which no educational credit is received.
A dependent care center qualifies if the center:
Cares for more than 6 individuals excluding those who reside at the facility;
Receives a fee, grant, or payment for services; and Complies with all applicable local and state laws.
In-home care qualifies if the individual daycare provider or babysitter:
Does not care for more than 6 individuals;
Is not the employee’s spouse, child under age 19, or someone for whom the employee (or the employee’s spouse) could claim a tax deduction for.
EXAMPLE OF NON-QUALIFYING EXPENSESCertain expenses cannot be reimbursed through the Dependent Care FSA. These include, but may
not be limited to:
Expenses for boarding or overnight camps, even if the camp is willing to split out the daycare portion from the overnight portion or summer school programs for which your child receives educational credit.
Child care or babysitting services provided by your spouse, or someone you claim as an exemption on your federal income tax return, or by one of your children under age 19.
Health care expenses for a dependent (these may be reimbursed only through your Health Care FSA).
Food or clothing expenses for a dependent.
Dependent care expenses you claim on your federal or state tax return.
Convalescent nursing home expenses for disabled spouse or dependent parent.
DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT CLAIMS FILINGYou may be reimbursed for Eligible Dependent Care Expenses, up to the amount in your Dependent Care FSA Account at that time. To submit a Dependent Care FSA claim, you must complete the claim form (available from the SAS Benefits Department, online through the SAS Benefits website, or the Claims Administrator’s website) and submit a paid receipt from your dependent care provider
Provider’s tax ID or social security number.
Dependent’s name that received care.
Dates on which the provider cared for your dependent.
Amount of Dependent Care Expenses.
Services are eligible for reimbursement only after your dependent actually received care, even if you prepaid for the services.
Individual daycare providers are also required to file these payments on their own income tax return upon receipt.
WHERE TO FILE CLAIMS
Flexible Spending Account claims should be submitted to the Claims Administrator:
Flores & Associates P.O. Box 31397 Charlotte, NC 28231-1397 Fax: 1-800-726-9982