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New Employee Benefits Enrollment - Dow Corning

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FLEXIBLE SPENDING ACCOUNTS (FSA)<br />

Eligibility to Contribute…<br />

Medical Plan <strong>Enrollment</strong> FSA Eligibility<br />

CDHP Option Select Limited Health Care FSA (dental and vision only).<br />

Enter the annual amount to contribute to this account.<br />

BCBS PPO<br />

HealthPlus HMO<br />

Anthem BCBS HMO<br />

UHC HMO<br />

You should know…<br />

Select Health Care FSA.<br />

Enter the annual amount to contribute to this account.<br />

� FSAs and HSAs are administrated by Wells Fargo. Visit https://healthbenefits.wellsfargo.com/<br />

for more information.<br />

� FSAs are an “at-risk” plan. Monies do not rollover year-to-year.<br />

� Participation in any flexible spending account requires annual re-enrollment.<br />

� Per IRS regulations, health care expenses for domestic partners CANNOT be reimbursed from<br />

your Health Care FSA.<br />

� Day care expenses for children of domestic partners can be reimbursed from Dependent Care<br />

FSAs if the child meets the definition of an eligible dependent.<br />

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