Bedford City School District offers three types of Flexible Spending Account (FSA) for 2024: Healthcare FSA, Limited Purpose FSA, and Dependent Care FSA.
If you have questions about your 2024 FSA, need to submit receipts, or want to check your balance, please visit the Inspira (formerly BRi) website:
The below information highlights some of the more important aspects of each plan. For more detailed information, refer to the full 2024 FSA Plan Document.
PLAN HIGHLIGHTS
The Employer maintains a Plan Document; if anything in this document conflicts with the Plan Document, then the Plan Document controls.
A. General Plan Information
1. Employer name: Bedford City School District.
2. Plan name: Bedford City School District Flexible Benefit Plan.
3. Plan type: The Plan is a welfare plan designed to provide benefits permitted under Section 125 of the Internal Revenue Code (IRC). The Plan name and Plan number should be used in any formal correspondence relating to the Plan.
4. Eligibility requirements: For Insurance Premiums, General Medical Flexible Spending Account (General Medical FSA) and Dependent Care Flexible Spending Account (Dependent Care FSA): Must be an employee of Bedford City School District. If you or your spouse is reporting contributions to a Health Savings Account (HSA), you are not eligible for a General Medical FSA. For a Limited Medical FSA: Must be an employee of Bedford City School District and does not participate in a General Medical FSA.
5. The effective date on which you can begin participating in the Plan: Once the eligibility requirements have been met.
6. Kinds of group insurance for which you can pay your share of premiums through the Plan: Medical Insurance.
7. The Plan Year begins on January 1 and ends on December 31.
8. Plan effective date: September 1, 2022.
9. Plan number: 501.
10. Employer ID number: 34-6000220.
11. Name, address and telephone number of the Plan Administrator:
Bedford City School District
475 Northfield Road
Bedford, OH 44146
(440) 786-3511
12. Agent for service of process: Bedford City School District.
B. Flexible Spending Accounts (FSAs)
1. Types of FSAs
General Medical FSA
(a) Maximum amount you can set aside per Plan Year for reimbursement of eligible medical expenses as defined by IRC Section 213(d) except for insurance premiums: $3,200.
(b) For active participants:
- Eligible services must be provided:
- after your effective date in the Plan and
- during the Plan Year.
(c) If you become ineligible (including termination of employment) during the Plan Year:
- Eligible services must be provided:
- after your effective date in the Plan,
- during the Plan Year and
- prior to the date on which you become ineligible.
- The Beniversal Card may no longer be used to access General Medical FSA funds. You may submit a claim for reimbursement of eligible expenses.
Limited Medical FSA
(a) Maximum amount you can set aside per Plan Year for reimbursement of eligible vision care and dental care expenses as defined by IRC Section 213(d): $3,200.
(b) For active participants:
- Eligible services must be provided:
- after your effective date in the Plan and
- during the Plan Year.
(c) If you become ineligible (including termination of employment) during the Plan Year:
- Eligible services must be provided:
- after your effective date in the Plan,
- during the Plan Year and
- prior to the date on which you become ineligible.
- The Beniversal Card may no longer be used to access Limited Medical FSA funds. You may submit a claim for reimbursement of eligible expenses.
Dependent Care FSA
(a) Maximum amount you can set aside per calendar year for reimbursement of eligible dependent care services, as defined by IRC Section 21(b), is limited to the smallest of the following amounts:
- $5,000 if single or if married and filing jointly; $2,500 if married and filing separately.
- The earned income of the participant.
- The earned income of the participant’s spouse.
(b) For active participants:
- Eligible services must be provided:
- after your effective date in the Plan and
- during the Plan Year.
(c) If you become ineligible (including termination of employment) during the Plan Year:
- Eligible services must be provided:
- after your effective date in the Plan and
- during the Plan Year in which you become ineligible.
- The Beniversal Card may no longer be used to access Dependent Care funds. You may submit a claim for reimbursement of eligible expenses.
2. Claims for FSAs
Claim submission time frames
(a) Claims must be received by Benefit Resource, LLC before the end of the 90 day run-out after the Plan Year ends.
(b) Claims denied during the run-out may be resubmitted, but must be received by Benefit Resource within 21 days after the run-out ends.
(c) Any funds remaining in your General, Limited Medical or Dependent Care FSA after this will be forfeited.
Claim reimbursements
(a) Complete your claim following all instructions.
(b) Claims received with proper documentation will be processed within 5 business days.
(c) Claim reimbursements are processed daily.
(d) There is a minimum reimbursement amount of $15 (except during the run-out after the end of the Plan Year).
(e) A claim should never be submitted for an expense that has been paid for with a Beniversal Card or reimbursed from any other source.
3. Beniversal Card for General, Limited Medical or Dependent Care FSA
(a) The Beniversal Card allows you to access General, Limited Medical or Dependent Care FSA funds to pay for eligible medical services at qualified merchants.
(b) The card may only be used to pay for eligible services after they have been provided. The IRS allows one exception: eligibility of orthodontia expenses can be based on either date of payment, date of service or payment due date on coupons/statements.
(c) Payment of a current Plan Year eligible service with the card must be completed before the Plan Year ends.
(d) Once a new Plan Year begins, only General, Limited Medical or Dependent Care FSA funds associated with the new Plan Year will be available on the card.
(e) You are advised to save all documentation related to medical expenses paid with your card, as IRS regulations require all transactions to be verified for eligibility.
(f) If a card transaction cannot be automatically verified, you will be contacted to submit documentation for that transaction.
(g) Eligible expenses paid with the card should never be submitted for claim reimbursement.