1. What is a Flexible Benefits Plan?
2. How will a Flexible Benefits Plan benefit the employer?
3. What are common benefits included in a Flexible Benefits Plan?
4. Can the employer continue with the same insured benefits and agent that I am currently using?
5. What is a Medical Reimbursement Plan?
6. What is a Dependent Care Plan?
7. What is a Transportation Reimbursement Plan?
8. Exactly how does a Flexible Benefits Plan work?
9. Can any Insurance Premiums be run through a Flexible Benefits Plan?
10. What is Premium Payment Plan?
11. What types of expenses qualify for Medical Reimbursement?
12. Can I use the Medical Reimbursement Plan to pay for my dependent’s medical expenses?
13. What types of expenses qualify for Dependent Care Reimbursement?
14. Does my Day Care provider need to be licensed?
15. Do I have to pay my doctor or daycare provider before I submit a claim?
16. Do I have to wait for the money to be withheld from my paycheck before I can use the funds?
17. Will I eventually be taxed on the funds I defer through the Flexible Benefits Plan?
18. What happens to my Flex Plan if I terminate employment during the plan year?
19. Can I change or revoke my elections during the plan year?
20. What constitutes a Change in Family Status?
21. Does it take long to receive my medical or dependent care reimbursement?
22. What types of over the counter medicines qualify for Medical Reimbursement?

What is a Flexible Benefits Plan?

It is sometimes called a Cafeteria or Section 125 plan and is governed by Section 125 of the Internal Revenue Code. In short, it is a plan, which allows employees to choose benefits best suited to their needs and have those benefits deducted from their pay before taxes are calculated. Some of the expenses that can be run through the plan are:  Medical, Dental, and Vision Premiums, Group Term Life Insurance Premiums, Disability Premiums, Transportation Expenses, Out of Pocket Medical expenses, and Dependent Care expenses.

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How will a Flexible Benefits Plan benefit the employer?

Because benefits are deducted from employee’s pay pre-tax, you will not pay FICA, Medicare, FUTA, and in some cases SUTA on the funds re-directed through the plan.

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What are common benefits included in a Flexible Benefits Plan?

Health, dental, vision, and life insurance premiums, transportation expense reimbursement, medical reimbursement, and dependent care plans are the most common benefits.

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Can the employer continue with the same insured benefits and agent that I am currently using?

Yes. Because Xpress Flex is not tied to an insurance provider and is not licensed to sell insurance, you are free to use the Agent or Insurance Provider of YOUR choice.

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What is a Medical Reimbursement Plan?

A Medical Reimbursement plan allows employees to pay for out-of-pocket medical and dental expenses with pre-tax dollars.

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What is a Dependent Care Plan?

A Dependent Care Plan allows employees to pay for expenses incurred for the care of children or a disabled dependent so the employee and spouse can work.

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What is a Transportation Reimbursement Plan?

A Transportation Reimbursement Plan allows employees to be reimbursed for expenses incurred for employment commuter transportation expenses.

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Exactly how does a Flexible Benefits Plan work?

Each year employees estimate their medical and dependent care expenses and complete and enrollment form. Based on the employee’s election a portion of the estimated annual amount is deducted from their pay pre-tax. When the employee visits a doctor, gets a prescription, or incurs a child care expense, they simply attach the invoice or billing statement to a claim form and submit for reimbursement. It’s that simple!

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Can any Insurance Premiums be run through a Flexible Benefits Plan?

Generally, only insurance premiums deducted from employees paycheck are covered. This may include: Health, Dental, Vision, Group Term Life, AD&D, Disability, and certain Cancer premiums. It is possible to have individual Health, Dental Vision, or Disability premiums deducted through a Flexible Benefits Plan; however, the employer would need to sponsor a Premium Payment Plan.

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What is Premium Payment Plan?

A Premium Payment Plan allows employees to be reimbursed for Individual Health, Dental, Vision, or Disability premiums. (Not a group sponsored plan)

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What types of expenses qualify for Medical Reimbursement?

You may be reimbursed for those types of medical expenses generally deductible on your federal income tax return. However, you are not subject to the 7.5% of adjusted gross income rule. Some examples are:

• Medicine, drugs, vaccines, and vitamins your doctor prescribes.

• Medical doctors, dentists, eye doctors, chiropractors, osteopaths, podiatrists, psychiatrists, psychologists, physical therapists, acupuncturists, and psychoanalysts (medical care only).

• Medical examination, lasik surgery, X-ray and laboratory service, insulin treatment, and whirlpool baths the doctor prescribes.

• Nursing help. If you pay someone to do both nursing and housework, you can be reimbursed only for the cost of the nursing help.

• Hospital care (including meals and lodging), clinic costs, and lab fees.

• Medical treatment at a center for chemically dependant individuals.

• Medical aids such as hearing aids (and batteries), dentures, eyeglasses, contact lenses (including solutions), orthodontic appliances, orthopedic shoes, crutches, wheelchairs, guide dogs and the cost of maintaining them.

• Ambulance service and other travel costs to get medical care. If you use your own car, you can claim 14 cents a mile. Add parking and tolls to the amount you claim under either method.

• Massage by a licensed therapist.

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Can I use the Medical Reimbursement Plan to pay for my dependent’s medical expenses?

Yes. The Medical Reimbursement Plan benefits can be used for any dependent you can claim on your annual income tax return. This is also true regardless of whether or not the dependent is covered under your company’s insurance plan.

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What types of expenses qualify for Dependent Care Reimbursement?

Expenses incurred for the care of a child, elderly parent, or disabled dependent so that you and your spouse can work.

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Does my Day Care provider need to be licensed?

If your provider cares for less than 6 children he/she does not need to be licensed. They do, however, need to be willing to include the money you pay them as income on their taxes at the end of the year. 

If your provider cares for more than 6 children he/she does have to be licensed.

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Do I have to pay my doctor or daycare provider before I submit a claim?

No. You just need to incur an expense by having a service provided for you. Keep in mind that the service must be provided during the plan year, regardless of when you are billed or pay for the expense.

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Do I have to wait for the money to be withheld from my paycheck before I can use the funds?

It depends on the benefit. With Medical Reimbursement, you may be reimbursed for the entire annual election amount the day the plan year begins. For Dependent Care Reimbursement, only the funds you have had withheld from your paycheck will be available to you at the time you submit your claim. 

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Will I eventually be taxed on the funds I defer through the Flexible Benefits Plan?

Be assured you will never be taxed on the funds you defer through your Flexible Benefits Plan. Remember, the IRS allows your employer to offer you this plan.

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What happens to my Flex Plan if I terminate employment during the plan year?

As of the last day of the month of your termination, you will no longer be eligible to participate in the Medical Reimbursement or Dependent Care plan. If there are more than 20 employees in your company you may be eligible to continue coverage under COBRA. COBRA applies for the Medical Reimbursement or Health Insurance Plans only.

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Can I change or revoke my elections during the plan year?

Generally no. However, if you have a change in family status, you will be allowed to make a change.

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What constitutes a Change in Family Status?

Generally, a change in family status is:

• Birth or adoption of a child

• Marriage or Divorce

• Loss of dependent either through death or the dependent moves out of the household.

• Change in job status by employee or spouse from part time to full time or vice versa.

• Termination of employment 

• Unpaid Leave of absence.

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Does it take long to receive my medical or dependent care reimbursement?

No. We make it both quick and easy for you to receive your reimbursement:

• Claims may be faxed or mailed
• Claims are processed daily
• Claims are paid by check or Direct Deposit

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What types of over the counter medicines qualify for Medical Reimbursement?

The IRS has released guidelines that state any MEDICINE purchased over the counter can be reimbursed through a medical reimbursement plan. Medicines are things such as pain relievers, allergy medications, cold medicines, antacids, etc.

While this is an exciting change, please understand the guidelines specifically state participants cannot be reimbursed for anything that is “merely beneficial to the general health of an employee”. This would include vitamins and other dietary or nutritional supplements.

However, if your doctor prescribes a dietary or nutritional supplement to treat an existing medical condition the expense is qualified on the plan. For this to be a covered expense you must include a copy of your prescription when you submit a claim.

The over-the-counter medicines are limited to 1 package of each medication at a time and must be purchased in the USA.

All claims must have an itemized receipt showing product name and dollar amount. If the receipt is unclear, have your service provider list the item and sign the receipt.

Here are some examples of qualified over-the-counter medicines:

The following are not qualified expenses:

First aid items such as band aides, gauze, tape, etc.
Ace bandages and ice packs.

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