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 27 through November 17. 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 employees 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 FSA Election Form and return the signed, original copy to the Payroll Department by November 17 (or the next business day if November 17 falls on a weekend). This is a strict deadline and exceptions are not permitted. Please carefully review the Flexible Spending Account packet before deciding if this Plan is right for you. Elections are irrevocable for the plan period, unless a qualifying life event occurs, such as death, birth of child, divorce, or loss of employment.

USE IT OR LOSE IT! Money left in your account at the end of the plan period (i.e., December 31) is lost. Health Care and Dependent Care Reimbursement Accounts are separate and distinct accounts that cannot be co-mingled. You must claim all money due to you by the end of the grace period, which is 90 days after the Plan Year ends (i.e., March 30), or else you will forfeit the money.

REIMBURSEMENT INSTRUCTIONS: Claims must total at least $50 and be accompanied by an Explanation of Benefits Form from the insurance company showing the 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 recordkeeper, FBA National.

Please note you will be charged a $50.00 annual administrative fee for this service.

FBA National
100 Quentin Roosevelt Blvd., Suite 403
Garden City, NY 11530
www.fbanational.com
(855) 374-6431