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WESTERN SUFFOLK BOCES
FLEXIBLE BENEFIT PROGRAM
WESTERN SUFFOLK BOCES
FOREWORD
Western Suffolk BOCES is pleased to announce the establishment of the Western Suffolk BOCES Flexible Benefit Program. This will enable you to obtain existing benefits with pre-tax dollars rather than the present program where the employees' share of premiums and additional medical expenses are paid out of after-tax dollars. This program is established according to Section 125 of the Internal Revenue Service Regulations. The program will allow you to pay medical, dental premiums and expenses, child care or dependent expenses, with pre-tax dollars, thereby saving you approximately 25 to 30% on income taxes and Social Security costs. It is recommended that you review all of the material enclosed in this booklet. You may wish to review this material with your accountant or tax advisor prior to completing the Election Form. WESTERN SUFFOLK BOCES FLEXIBLE BENEFIT PROGRAM
GENERAL INFORMATION
A Flexible Benefit Program is a Program set up under IRS 125 regulations, which allows employees to choose between non-taxable fringe benefits and taxable compensation. Your annual salary will be reduced by an amount that you determine and place in one or more of the flexible spending accounts: Health Coverage Premiums, Medical Reimbursement Account, and Dependent Care Account. In short, Western Suffolk BOCES’ Flexible Benefit Program gives you a choice of paying for Health or Dependent Care expenses with pre-tax dollars. The Flexible Benefit Program will not affect employee pensions under the New York State Teachers’ Retirement System or the Employees’ Retirement System. The New York State Legislature, with the adoption of Chapter 760 of the Laws of 1989, eliminated any reductions in retirement benefits as a result of this Program. If your salary is above the current maximum subject to FICA deductions, the amount of salary reduction will not impact your Social Security benefits. If your salary is below the Social Security limit, there could be a slight adjustment in your Social Security benefits. It should be noted that leading experts indicate that if the savings from a flexible account are placed in an interest bearing account, this will more than compensate for the Social Security offset. Western Suffolk BOCES will reduce your salary to pay for your applicable premiums before taxing your bi-weekly pay. MEDICAL REIMBURSEMENT ACCOUNT (See page 7) You can request to reduce your salary by the amount you anticipate will be needed to cover the costs of unreimbursed medical expenses for you and/or your dependents. WESTERN SUFFOLK BOCES FLEXIBLE BENEFIT PROGRAM
GENERAL INFORMATION
(Continued)
DEPENDENT CARE ACCOUNT (See Page 9) In addition to certain medical expenses, the Flexible Benefit Program allows participants to submit expenses for day care of eligible children or other dependents provided they can be claimed as a dependent on your tax return. The dependent day care expenses are covered only if the dependent is under age 13, or the dependent, regardless of age, is physically or mentally incapable of self-care. A decision to redirect part of your income through the Western Suffolk BOCES Flexible Benefit Program to pay for health and/or dependent care expenses before taxation may be made only once each Plan Year prior to January 1st. By Law, the election is irrevocable during the Plan Year, except in cases of a change in family status, employment, or change in spouse’s employment. When a participant elects to have a certain amount of earnings withheld, that amount must be used to pay for benefit expenses that are incurred in the Plan Year. Any unused monies at year-end will be forfeited. Furthermore, unused funds cannot be carried over to the next year or given back to the participant either in cash, year-end bonus, or an adjusted salary income. The biggest advantage of the Flexible Benefit Program is the savings in Federal and State taxes. You may notice an increase in your net pay and a reduction in the taxes withheld. The reduction in gross salary will be shown on the W2 at the end of the year. In other words, the more you use the Program, the lower your tax base and the greater your tax savings. WESTERN SUFFOLK BOCES FLEXIBLE BENEFIT PROGRAM
WORKSHEET
This worksheet is provided for your convenience in determining the cost of the benefits you choose. Please take time to answer the questions on this form which apply to you. You may want to review your Personal Benefit Profile, checkbook register and medical/dental records to help you complete this form. BEFORE-TAX OPTIONAL BENEFITS
_________________________________________________________________
MEDICAL REIMBURSEMENT
Estimate your annual health expenses NOT COVERED by your medical/dental
insurance:
Vision Care (eye exams, contact lenses, glasses) Routine exams (Ob-Gyn, School Physicals)
DEPENDENT CARE
Estimate your child care expenses for your child/
children under age 13 if you and your spouse work
Estimate your child care expenses for your disabled dependents (children over age 13, parents) who are unable to care for themselves WESTERN SUFFOLK BOCES FLEXIBLE BENEFIT PROGRAM
ELECTION FORM
Each year, all employees must complete a new Election Form for the next Plan Year. All Plan Years are traditionally January 1 through December 31. By Law, this Election is irrevocable during the Plan Year, except in cases of a change in family status, employment, or change in spouse’s employment. The present IRS guidelines permit employees to change their election only for the following: 1. Change in legal marriage status 2. Change in number of dependents 3. Change in employment status 4. Change in work schedule 5. Change in place of residence or worksite A worksheet is provided in the Plan Booklet to assist you in determining the eligible expenses. This form should be consulted before completing the Election Form. WESTERN SUFFOLK BOCES FLEXIBLE BENEFIT PROGRAM
BENEFIT PREMIUMS
Western Suffolk BOCES will automatically reduce your salary for the employee share of the premiums of the eligible benefits. Your bi-weekly gross salary will be reduced by the amount of the premiums. The remaining salary will then be taxed. You may reduce your salary to pay for applicable premiums for benefits provided by the Western Suffolk BOCES. The most obvious advantage in paying premiums with before-tax dollars is that there is often an increase in take-home pay. If you do not wish to have your salary reduced for payment of your share of premiums before taxes, please sign the Election Form in the appropriate area. You will then pay taxes on your premiums. WESTERN SUFFOLK BOCES FLEXIBLE BENEFIT PROGRAM
MEDICAL REIMBURSEMENT ACCOUNT

This option allows employees to withhold from pay future dollars to pay for out-of-pocket health
expenses that are not covered under any medical or dental insurance program.
This account can be used to reimburse uncovered medical and dental expenses for the diagnosis,
treatment, of prevention of disease, and for treatments that are medically necessary affecting any part
or function of the body. Over-the-counter medicines and drugs must be used to alleviate or treat
personal injuries or sickness.
Effective January 1, 2011, over-the-counter medications can only be eligible when receipts are
accompanied by a doctor’s prescription or directive.
Effective January 1, 2013, the Medical Reimbursement Account has a cap of $2500 per
participating employee.

Eligible
Acupunture
Dental treatments**
Laser eye surgery**
Orthodontia**
**All out-of-network doctors, all dental, and all laser eye surgery claims must be
submitted using Explanation of Benefits from your insurance company.
Not Eligible
Cosmetic procedures
The expenses listed above are examples of medical and dental expenses that qualify under Section 213 of the tax code. Medical expenses that are not deductible under Section 213 may not be reimbursed. WESTERN SUFFOLK BOCES FLEXIBLE BENEFIT PROGRAM
MEDICAL REIMBURSEMENT ACCOUNT

Claims
Only expenses that are incurred in the Plan Year are eligible regardless of when they
are paid. Claims may be submitted to Western Suffolk BOCES at any time during the
year. The deadline for submission is February 28 of the following year for expenses
incurred in the previous year. Claim submissions must include the following:
Original Flexible Benefit Claim Form Original Explanation of Benefits from insurance company that includes the dates of service, amount of expense, and name of provider. “Year to date and balance due” statements are not acceptable. Original co-payment stubs or a computer print-out from the pharmacy that indicates the date of service, name of prescription and number, and amount paid. Cash register receipts are not acceptable for prescriptions. Original statements from providers when there is no insurance coverage. Employee must state on Flexible Benefit Claim Form that they do not have insurance coverage for that expense, i.e., eyeglasses. Original receipts that include the full name of the over-the-counter drugs.
Effective January 1, 2011, over-the-counter medications and drugs can only
be eligible when receipts are accompanied by a doctor’s prescription or
directive.

All income which was redirected to pay for medical expenses from the beginning
of the Plan Year to the date of cessation of employment will remain available in
the account until the end of that Plan Year. Employees are responsible for any
outstanding balances due at the time of the break in employment.
When a participant elects to have a certain amount of earnings withheld before
taxes are calculated and have those monies pay for benefits that are considered
non-taxable under IRS rules, the full amount withheld for that plan year must be
used to pay for benefit expenses that are incurred in that year.
Any unused monies at year-end will be forfeited by the participant.
Furthermore, unused funds in an account cannot be carried over to the next
year, given back to the participant either in cash, year-end bonus, or an
adjusted salary income.

WESTERN SUFFOLK BOCES FLEXIBLE BENEFIT PROGRAM
DEPENDENT CARE ACCOUNT
This account allows you to be reimbursed for expenses for day care for eligible dependents while you and your spouse are gainfully employed. IRS regulations state that an employee can only allocate up to $5,000 per household per year in a Dependent Care Account. Eligible dependents are defined by the IRS as: a dependent under age 13 for whom the employee is entitled to a tax deduction a dependent or spouse who is physically or mentally incapable of caring for himself or herself, such as an elderly parent who is in adult day care. An adult dependent, such as an employee’s parent, must have gross income that is less than $3,200. An adult dependent must live in the same house as the employee for more than half of the tax year.
Eligible
Baby-sitter or companions during work hours
A day care center must meet local and state regulations, provide care for more than 6 non-resident
people and receive a fee for such services.
Summer day camp while both parents are working
Not Eligible
Overnight camp
Kindergarten
Claims
All claims for reimbursement of Dependent Care expenses are paid after services are provided based
on the amount of contributions in the account at the time the claim is received by BOCES. The
deadline for submission is February 28 of the following year for expenses incurred in the previous
year. An original statement from the provider must include the following information:
The providers name, address and Tax ID or Social Security number The dates of service and a brief description of the services. The dependent(s) name and date of birth The amount paid for the service
All unused funds in the Dependent Care Account at year-end must be forfeited along with any
unreimbursed claims. Therefore, it is essential to use up the full account balance during the Plan
Year.

WESTERN SUFFOLK BOCES FLEXIBLE BENEFIT PROGRAM
IMPORTANT TELEPHONE NUMBERS
ADMINISTERED BY:
WESTERN SUFFOLK BOCES

Source: http://my.wsboces.org/documents/WESTERNSUFFOLKBOCESFLEXBENEFITBOOK2014updated.pdf