Section 125 Flexible Spending Account
The enrollment period for the Great Neck Public Schools Flexible Benefit Plan, which includes health and dependent care flexible spending accounts, is open annually from October 20 through November 20. The plan period is from January 1 through December 31.
THE PLAN CONSISTS OF TWO FLEXIBLE SPENDING OPTIONS:
1) Health Reimbursement Account
Allows you to set aside pre-tax money through payroll deductions for out-of-pocket health expenses that you incur (i.e., those not covered by your health or dental plan). These out-of-pocket expenses can be incurred by you, your eligible spouse, and/or eligible dependents.
2) Dependent Care Reimbursement Account
Allows you to set aside pre-tax money through payroll deductions for out-of-pocket expenses you incur for child and/or dependent care that enables you and/or your spouse to work. Examples of eligible expenses are baby-sitting, day care of children under age 13, or care for a dependent who is physically or mentally incapable of caring for him or herself. The tax identification number or Social Security number of the provider must be reported to the plan administrator for charges to be reimbursed.
ENROLLMENT INSTRUCTIONS: Eligibility applies to salaried, full-time, part-time, or hourly contractual employee of the Great Neck Public Schools. If you are presently enrolled in this Plan, you must re-enroll on an annual basis. Your contributions will not be automatically renewed from year to year. Complete the Section 125 Election Form and return the signed, original copy to the Payroll Department by November 20. This is a strict deadline and exceptions are not permitted. Please review the Flexible Spending Account packet carefully before deciding if this Plan is right for you.
REIMBURSEMENT INSTRUCTIONS: Claims must total at least $50 and be accompanied by an Explanation of Benefits Form from the insurance company showing out-of-pocket expense. All claims for reimbursement are to be submitted on the forms in the packet (also shown at right), and sent to the plan record keeper, FBA of Syosset.
Please note you will be charged a $44.50 annual administrative fee for this service.
FBA of Syosset
100 Quentin Roosevelt Blvd., Suite 502
Garden City, NY 11530