EMPLOYEE REIMBURSEMENT ACCOUNT - TASC - …

1 FLEX SPENDING ACCOUNTSH ealth Care | Limited Purpose Health Care | Dependent Day Care | Parking & TransitEMPLOYEE REIMBURSEMENT ACCOUNT Participant Reference ManualLast Revised: Dec. 2018 EMPLOYEE RESOURCESTASCC ustomer Care CenterPHONE: 844-786-3947 or 608-316-2408 HOURS: Monday-Friday, 8 am to 5 pm in all time zones MAILING ADDRESS: PO Box 7511 Madison, WI 53707 FAX: 877-231-1287 EMAIL: ONLINE: of Wisconsin Department of EMPLOYEE Trust FundsETF WEBSITE: ETF website provides a link to the ERA program information and forms, along with access to your personal ACCOUNT information. Click on the members tab at the top of the page, then select EMPLOYEE REIMBURSEMENT Accounts Program from the this booklet for your reference throughout the plan of ContentsGeneral Information.

2 1 Types of Accounts ..1 Contributions ..2 Eligible Expenses ..4 REIMBURSEMENT ..4 Participant Responsibilities ..5 Enrollment Information ..6 Enrollment Eligibility ..6 IRS Maximum Election Amounts ..6 Open Enrollement ..6 Mid-Year Enrollment ..8 Transfers ..9 Health Care Flex Spending ACCOUNT ..11 General Information ..11 Contribution Limits..11 Qualified Dependents ..12 Eligible and Ineligible Expenses ..13 Limited Purpose Flex Spending ACCOUNT ..18 General Information ..18 Contribution Limits..18 Qualified Dependents ..18 Eligible and Ineligible Expenses ..19 Dependent Day Care Flex Spending Accounts ..20 General Information ..20 Contribution Limits..20 Qualified Dependents.

3 21 Elder Care ..22 Eligible and Ineligible Expenses ..23 Dependent Day Care Flex Spending ACCOUNT vs. Child Care Tax Credit ..23 Dependent Day Care Flex Spending ACCOUNT and the TASC Card ..24 Parking & Transit ACCOUNT ..25 General Information ..25 Contribution Limits..25 Eligible and Ineligible Expenses ..26 Election Changes ..26 Parking & Transit ACCOUNT and the TASC Card ..26 REIMBURSEMENT Information ..27 REIMBURSEMENT Options ..27 REIMBURSEMENT Request Tips ..27 Deadlines for Requesting REIMBURSEMENT ..27 REIMBURSEMENT Denial Appeal Process ..28 TASC Card ..29 General Information ..29 Using your TASC Card ..30 Inventory Information Approval System (IIAS) ..32 TASC Card Substantiation.

4 32 Carryover ..35 General Information ..35 Carryover Limits ..35 Runout Period ..35 Carryover Process ..36 Access to Carryover Funds ..36 Timing Carryover ..36 Carryover Scenarios ..37 Change in Status During the Year ..38 General Information ..38 Effective Date ..38 Request a Change of Election ..39 Qualifying Event Changes Permitted by IRS ..40 Termination of Employment ..43 Retirement ..44 Divorce ..45 Death ..45 Impact of ERAs on Social Security, WRS, and Other Benefits ..46 Social Security ..46 Wisconsin Retirement System and Other State Benefits ..46 Tax-sheltered Annuities and Deferred Compensation ..46 TASC ACCOUNT Website ..47 Online ACCOUNT Management ..47 Initial Access.

5 47 Profile Settings ..48 ACCOUNT Summary ..49 Online Request for REIMBURSEMENT ..51 Online Substantiation Submission ..56 Manage Your TASC Card ..58 Direct Deposit ..58 Statements and Notifications ..59 MyTASC Mobile App ..60 Mobile App Download ..60 Mobile App Log In ..60 Request for REIMBURSEMENT ..61 Adding Receipts to Claims..61 Getting Help ..62 Participant Communications ..63 Appendix ..69 Glossary ..70 Receipt Request Process ..71 Forms ..72 Authorization for Release of Information Form ..73 Change of Address Form ..74 Change of Election Form ..75 Claim Repayment Form ..77 Dependent Care Contract ..78 Direct Deposit Authorization Form ..79 ERA Enrollment Form ..80 Late Enrollment Request Form.

6 85 Letter of Medical Necessity ..87 Orthodontia Contract..88 Payroll Transfer Form ..89 Plan Correction Request Form ..90 Request for REIMBURSEMENT Form ..92 Unsubstantiated Claim - Business Debt Appeal ..93 Additional Debit Card Request ..95 TASC Cardholder Agreement ..96 TASC Mobile App Information Flyer ..98 ERA Enrollment Brochure ..99 Welcome ..100 ERA Overview ..101 Health Care FSA ..102 Limited Purpose FSA ..104 Dependent Day Care FSA ..106 How to Enroll ..109 ERA Annual Expense Estimate Worksheet ..111 TASC Tools ..112 Commuter Benefit Program Enrollment Brochure ..113 Welcome ..114 Overview ..115 Parking ACCOUNT ..116 Transit ACCOUNT ..117 How to Enroll ..118 TASC Tools.

7 1201^ BACK TO TABLE OF CONTENTSG eneral InformationThe EMPLOYEE REIMBURSEMENT Accounts (ERA) program is an optional benefit established for eligible state employees. Also referred to as Flex Spending Accounts, or FSAs. The ERA Program is authorized under Sections 125, 105, and 129 of the Internal Revenue Code and Wisconsin Statutes The ERA Program allows you to pay for eligible expenses using your pretax income rather than after tax Flex Spending ACCOUNT is offered through your employer (State of Wisconsin) and administered by plan year begins on January 1. After that, you may change enrollment elections only if a change of status qualifying event affects your eligibility to participate in the Flex Spending ACCOUNT .

8 Submit any change of status qualifying event information to your Payroll/Benefits Office for more about change of status qualifying events and how to request a change, refer to the Change of Status of AccountsThe EMPLOYEE REIMBURSEMENT Accounts (ERA) program has three pretax benefit ACCOUNT options: The Health Care Flex Spending ACCOUNT is a pretax benefit ACCOUNT used to pay for eligible health care expenses that are not reimbursed by your medical, dental, or vision care insurance plan. See Health Care Flex Spending ACCOUNT section for more information. The Limited Purpose Health Care Flex Spending ACCOUNT is a pretax benefit ACCOUNT if you are enrolled in the HDHP health insurance plan used for eligible dental and vision care expenses.

9 See Limited Purpose Health Care Flex Spending ACCOUNT Section for more The EMPLOYEE REIMBURSEMENT ACCOUNT (ERA) and Flex Spending ACCOUNT (FSA) terms can be used interchangeably. This guide uses Flex Spending ACCOUNT (FSA) terminology CONTENTST ypes of AccountsContributionsLimits Availability of ContributionsEligible ExpensesReimbursementParticipant ResponsibilitiesReceipts/DocumentationFo llow-UpContact InformationAdhere to Plan RulesREDUCE YOUR TAXESThe more you contribute to these accounts, the more you reduce your taxable gross ^ BACK TO TABLE OF CONTENTSC ontributionsWhen you enroll in a TASC Heath Care Flex Spending ACCOUNT , Limited Purpose Health Care Flex Spending ACCOUNT , Dependent Day Care Flex Spending ACCOUNT , and/or Parking & Transit ACCOUNT , you determine how much to contribute to each ACCOUNT .

10 The dollar amount is based on your estimated expenses for the upcoming plan year. Your contributions deduct in equal amounts from each paycheck, pretax, throughout the plan year, the IRS establishes ERA contribution dollar limits. The most up-to-date information regarding limits per plan is below. Meanwhile, there is no minimum ERA election S MY BUDGET?Determine how much money you need to set aside. Plan carefully. The Dependent Day Care Flex Spending ACCOUNT is a pretax benefit ACCOUNT for dependent day care expenses incurred for the care of your eligible dependents under age 13, or a spouse or other tax dependent who is physically or mentally incapable of caring for him/herself, so that you can work.