Providence Engineering - 2023 Benefits Guide

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HEALTH SAVINGS ACCOUNT CARRIER: HealthEquity MAXIMIZE YOUR TAX SAVINGS • Contributions to an HSA are tax-free and can be made through payroll deductions on a pre-tax basis. • The money in your HSA (including interest and investment earnings) grows tax-free. • As long as you use the funds to pay for qualified medical expenses, the money is spent tax-free. YOU INDIVIDUALLY OWN YOUR HSA • You own and administer your HSA. • You determine how much you will contribute to your account and when to use the money to pay for eligible health care expenses. • You can change your contributions at any time during the plan year without a qualifying event. • Like a bank account, you must have a balance in order to pay for eligible health care expenses. • Keep all receipts for tax documentation. • An HSA allows you to save and “rollover” money from year to year. • The money in the account is always yours, even if you change health plans or jobs. • There are no vesting requirements or forfeiture provisions. ACCESSING YOUR HSA FUNDS Debit Card: Draws directly from your HSA and can be used to pay for eligible expenses at your doctor’s office, pharmacy, or other locations where you purchase health related items or services. USE YOUR HSA TO PAY QUALIFIED MEDICAL EXPENSES • You can use your HSA money to pay for eligible expenses now or in the future. • Funds in your HSA can be used for your expenses and those of your spouse and eligible dependents, even if they are not covered by the HDHP Plan. • Eligible expenses include deductibles, doctor’s office visits, dental expenses, eye exams, prescription expenses and LASIK eye surgery. • A complete list of eligible expenses can be found at www.irs.gov • You can also visit this link for for further information from Healthequity: HSA Resource Center 12
FLEXIBLE SPENDING ACCOUNTS CARRIER: iSolved Benefit Services <strong>Providence</strong> offers two Flexible Spending Account (FSA) options – the Health Care FSA and the Dependent Care FSA – that allow you to pay for eligible health care and dependent care expenses with pre-tax dollars. Log into your account at www.isolvedbenefitservices.com to view your account balance(s), calculate tax savings, view eligible expenses, download forms, view transaction history, and more. HEALTH CARE FSA • Set aside pre-tax money from your paycheck to pay for eligible out-of-pocket expenses, such as deductibles, copays, and other health-related expenses, that are not paid by the medical, dental, or vision plans. • Over-the-counter (OTC) medications are eligible for reimbursement without a prescription. DEPENDENT CARE FSA • Set aside pre-tax money from your paycheck for daycare expenses when you and your spouse work or attend school full time. • Eligible dependents are children under age 13, or a child over 13, spouse, or elderly parent residing in your house who is physically or mentally unable to care for himself or herself. • Examples of eligible expenses are daycare facility fees, before and after-school care, and in-home babysitting fees (income must be reported by your care provider). Refer to the official Summary Plan Document for a list of eligible expenses to maximize the Value of your Flexible Spending Account. HEALTH CARE FSA $3,050 $5,000 DEPENDENT CARE FSA $2,500 married filing jointly or single / head of household married filing separately 13
Page 1 and 2: 2023 BENEFITS ENROLLMENT GUIDE
Page 3 and 4: CONTENTS 4-5 Benefits Overview 6-10
Page 5 and 6: BENEFITS OVERVIEW ELIGIBILITY Full-
Page 7 and 8: WHICH MEDICAL INSURANCE PLAN IS RIG
Page 9 and 10: TELEMEDICINE / VIRTUAL VISITS When
Page 11: HEALTH SAVINGS ACCOUNT CARRIER: Hea
Page 15 and 16: DENTAL INSURANCE CARRIER: Sun Life
Page 17 and 18: VISION INSURANCE CARRIER: Sun Life
Page 19 and 20: GROUP LIFE INSURANCE CARRIER: Sun L
Page 21 and 22: EMPLOYEE VOLUNTARY LIFE INSURANCE R
Page 23 and 24: VOLUNTARY ACCIDENT INSURANCE CARRIE
Page 25 and 26: VOLUNTARY CRITICAL ILLNESS INSURANC
Page 27 and 28: DEPENDENT VOLUNTARY CRITICAL ILLNES
Page 29 and 30: OPEN ENROLLMENT INSTRUCTIONS During
Page 31 and 32: COMPLIANCE DISCLOSURES PLEASE NOTE:
Page 33 and 34: COMPLIANCE DISCLOSURES PREMIUM ASSI
Page 35 and 36: COMPLIANCE DISCLOSURES HIPAA PRIVAC
Page 37 and 38: COMPLIANCE DISCLOSURES HIPAA PRIVAC
Page 39 and 40: COMPLIANCE DISCLOSURES Model Genera
Page 41 and 42: GLOSSARY Coinsurance: Your share of

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