Flexible Spending Accounts

Flexible Spending Account (FSA) is a benefit governed by the IRS and sponsored by your employer. A FSA allows you to pay certain Health Care and/or Dependent Care expenses with pre-tax money. Money is diverted out of each of your paychecks on a pre-tax basis and put into a Health Care Reimbursement Account and/or a Dependent Care Assistance Account.

Health and Dental Insurance Premium Offset: You may have your premium co-payments deducted on a pre-tax basis. This will reduce your gross pay and as such your tax liability.

Dependent Care: This also allows you to have a pre-tax payroll deduction for daycare expenses. Since this is also pre-taxed, it reduces your gross pay and as such, your tax liability.

***NOT ALL OVER THE COUNTER MEDICINES AND ITEMS REQUIRE A DOCTOR'S PRESCRIPTION***

If you want a good reference to see exactly which items do not require a prescription, click on the FSA Store Banner at the bottom of Benefit Strategies home page and look at the list on the left. Items in red do not require a doctor's prescription and the items listed in blue do require a doctor's prescription. Please know that the City is not endorsing that you purchase from that site, it is simply a great listing of what does or does not require a prescription.

INFORMATION

FORMS

Summary Plan Description
Plan Description which explains the Flexible Spending Plan and provides details of the plan.
Simplifying Health Care Reform
How Health Care Reform changed the Flexible Spending Accounts
Flexible Benefits Pamphlet
Detailed information on the Health Care Reimbursement Account and the Dependent Care Assistant Account.
Health Care Reimbursement Account Brochure
Overview of Health Care Reimbursement Account program.
Dependent Care Account Brochure
Overview of the Dependent Care Assistance program.
Flexible Benefit Debit Card Guidelines
Guidelines for your Flex Express Debit Card.
Eligible Over the Counter Expenses List
Listing of specific over the counter medications effective 1/1/2011.
Benefit Strategies Website Instructions
Instructions on how to create or log in to your account with Benefit Strategies.
Mobile Technology Brochure
Information on accessing your flexible spending accounts thru the phone.

Enrollment Form (7/1/13 - 6/30/14)
This enrollment form is for the full Plan Year beginning 7/1/2013 through 6/30/2014.

These Flexilble Enrollment Forms are used to enroll in the Health Care Reimbursement Account, Dependent Care Assistant Account, or elect your health and dental premiums to be deducted pre-tax.
Direct Deposit Authorization Form
Form used to request that your reimbursements for your Health Care Reimbursement Account or Dependent Care Assistant account be directly deposited to your specified checking or savings account.
Participant Status/Change Form
If you have a qualifying event during the calendar year; such as marriage/divorce, etc. and need to change your flexible benefit contributions complete this form and send it to HR; Attn: Benefits.
Reimbursement Request Form
Claim Form to request reimbursement from your Health Care Reimbursement Account or your Dependent Care Assistance Account.
Physician Statement Form
If you have an existing disease, have your doctor fill this form.

CONTACT INFORMATION

Benefits Strategies, LLC

Mailing Address:
Benefits Strategies
P.O. Box 1300
Manchester, NH 03105-1300

Physical Address:
967 Elm Street
Manchester, NH 03101

Customer Service Phone: (603) 647-4666
Hours of Operation: Mon-Thurs 8:00 a.m. to 6:00 p.m. and Friday 8:00 a.m. to 5:00 p.m.
Fax # for claims: (603) 647-4668
Email: info@benstrat.com