Combined Services LLC
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Medical Reimbursement Accounts - Section 105		 Medical Reimbursement Accounts - Section 105
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Medical Reimbursement Accounts - Section 105
FSA Do you find that some of your medical or dental expenses each year are not covered by insurance?

Do you pay for child care so that you and your spouse can work?
Medical Reimbursement Accounts - Section 105
If you answered "yes" to either of these questions, you may be able to save money by using a Flexible Spending Account (FSA). A Flexible Spending Account enables you to pay for uncovered medical expenses or for dependent care expenses with pre-tax dollars.

Topics Discussed:
Medical Reimbursement Accounts - Section 105
• Types of Accounts • Claims
Medical Reimbursement Accounts - Section 105
• Savings Illustration • On-Line Account Information
Medical Reimbursement Accounts - Section 105
• Important Considerations • Debit Cards
Medical Reimbursement Accounts - Section 105
• Reimbursement • Contact Us


Combined Services LLC
Medical Reimbursement Accounts - Section 105
Here's How it Works
Medical Reimbursement Accounts - Section 105
Back to Top		 Medical Reimbursement Accounts - Section 105 You elect an amount to set aside up to them maximum election set by your employer's plan. The money you deposit in your FSA is automatically deducted from your gross pay before federal income tax and FICA are calculated. Your FSA deposits are not considered current taxable income and therefore do not appear on your W-2 form as taxable income. Since your taxable income is reduced, so are your annual taxes.
Medical Reimbursement Accounts - Section 105
After a reimbursable expense has been incurred, you submit a reimbursement form with an itemized bill or receipt. You will be reimbursed for all eligible expenses in tax-free dollars.
Medical Reimbursement Accounts - Section 105
Combined Services LLC
Medical Reimbursement Accounts - Section 105
Employee Tax Savings Illustration with Flexible Spending Account
Medical Reimbursement Accounts - Section 105
Back to Top		 Medical Reimbursement Accounts - Section 105

You elect an amount to set aside up to them maximum election set by your employer's plan. The money you deposit in your FSA is automatically deducted from your gross pay before federal income tax and FICA are calculated. Your FSA deposits are not considered current taxable income and therefore do not appear on your W-2 form as taxable income. Since your taxable income is reduced, so are your annual taxes.
Medical Reimbursement Accounts - Section 105
After a reimbursable expense has been incurred, you submit a reimbursement form with an itemized bill or receipt. You will be reimbursed for all eligible expenses in tax-free dollars.

Would you like to see how much an FSA could save you?
Try our FSA Calcualtor.
Medical Reimbursement Accounts - Section 105
Combined Services LLC
Medical Reimbursement Accounts - Section 105
Two Types of Flexible Spending Accounts
Medical Reimbursement Accounts - Section 105
Back to Top		 Medical Reimbursement Accounts - Section 105 There are two types of Flexible Spending Accounts, a Health Flexible Spending Account and a Dependent Care Flexible Spending Account. The amounts you decide to set aside in one, or both, of these accounts during the year will be deducted in equal amounts from each paycheck and credited to your account. Then, when you have an eligible expense, you can apply for reimbursement from your account. There¹s a reimbursement request form you¹ll need to complete. You¹ll also need to provide bills and receipts that clearly state the type and amount of expense you have incurred, the date the expense was incurred (not paid), and the name of the service provider.
Medical Reimbursement Accounts - Section 105
Health Flexible Spending Accounts (HFSA)
Medical Reimbursement Accounts - Section 105
Medical expenses must first be filed with your health plan. Their ³Explanation of Benefits² showing unpaid amounts, can then be submitted for reimbursement. You may gather several small bills and submit them together (the minimum payment you can receive is $40.00 unless it¹s your end of the year claim)
Medical Reimbursement Accounts - Section 105
The Health FSA will reimburse you the amount of your claim up to your specified annual contribution. Your HFSA reimburses you for expenses incurred for eligible services. We will not issue checks to doctors or drug stores, but will reimburse you directly.
Medical Reimbursement Accounts - Section 105
Dependent Care Flexible Spending Accounts (DCFSA)
Medical Reimbursement Accounts - Section 105
The Dependent Care Flexible Spending Account is for child and dependent care expenses incurred to allow you (and your spouse if you are married) to work. The dependent on your income tax return must be under 13 (or incapable of self-care) and be claimed as a dependent. The rules for eligible expenses are the same as those for the Child and Dependent Care Credit which are outlined in IRS Publication 503.
Medical Reimbursement Accounts - Section 105
Combined Services LLC
Medical Reimbursement Accounts - Section 105
Claims for Health & Dependent Care Flexible Spending Accounts
Medical Reimbursement Accounts - Section 105
Back to Top		 Medical Reimbursement Accounts - Section 105 Expenses for either account must be incurred during your group¹s plan year. You will have a 90-day run-off period (after the plan year-end) to submit your claims for reimbursement. We will try to help you use the Flexible Spending Accounts only for eligible expenses. However, your employer and the claims administrator bear no responsibility for your taxes. You remain fully accountable to the IRS to prove the eligibility of any expense you submit. Therefore, you should keep copies of all receipts for your tax records.
Medical Reimbursement Accounts - Section 105
Combined Services LLC
Medical Reimbursement Accounts - Section 105
How Do I Request Reimbursement
Medical Reimbursement Accounts - Section 105
Back to Top		 Medical Reimbursement Accounts - Section 105 Complete a Reimbursement Request Form. You can download this from our website. There are a few requirements when submitting for a Reimbursement Request:
Medical Reimbursement Accounts - Section 105
• Include third-party verification with your request (a receipt from the provider or an Explanation of Benefits from your insurance company).
• The receipt must have the date of service (not the date you paid the bill); name and credentials of the provider; amount charged for the service; description of the service provided; and, name of the individual who received the service.
• Cancelled checks are not sufficient documentation.

Medical Reimbursement Accounts - Section 105
If you have any questions, you can contact a representative from our Flexible Benefits Department, Monday through Friday from 8:00am-4:30pm (extended hours Tuesday & Thursday until 5:30pm) who would be happy to assist you.
Medical Reimbursement Accounts - Section 105
Combined Services LLC
Medical Reimbursement Accounts - Section 105
Debit Card
Medical Reimbursement Accounts - Section 105
Back to Top		 Medical Reimbursement Accounts - Section 105 For Employers who offer a Debit Card option, Employees have the ability to pay for eligible expenses at the point-of-service. For example, at the pharmacy counter or at the physician/dentists office you can pay for your co-payment on the spot! It is important to save all documentation as you may be requested to present copies to Combined Services LLC for verification of purchase of an eligible item.
Medical Reimbursement Accounts - Section 105
Q. Why have I received an e-mail requesting information about my MBI debit card purchase?
Medical Reimbursement Accounts - Section 105
A. When you use your Flexible Benefits mbi debit card, you are required to submit an itemized bill or receipt for the services or purchase paid for with the card that do not match office visit or prescription co-pay amounts set up for your account. If the amount you purchased on the mbi card does not match one of your co-pay amounts, a notification is sent to you requesting documentation for the purchase of goods or services. You can have the notification mailed by US Postal Service or by e-mail.
Medical Reimbursement Accounts - Section 105
If you do receive a request for documentation, simply submit the documentation requested along with the notification to Combined Services LLC. You can mail, fax or e-mail the documentation back to Combined Services LLC.
Medical Reimbursement Accounts - Section 105
Q. Why is my MBI debit card being declined?
Medical Reimbursement Accounts - Section 105
A. There are a few common reasons that an mbi card may be declined. If your card has been temporarily inactivated, you should contact Combined Services LLC at 1 888 227-9745 ext. 2040 to have the card reactivated.
• Did you make a purchase on the mbi card previously that did not match your co-pay amounts and forget to submit documentation?
• Is there enough money set aside in your account to make the purchase on your card?
• Did your last purchase meet IRS guidelines as reimbursable Health or Dependent Care expense(s)? If not, will need to contact Combined Services LLC.
Medical Reimbursement Accounts - Section 105
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