OPEN ENROLLMENT FOR 2017 SECTION 125
Forms Accepted: October 12, 2016 - November 15, 2016 for 2017 calendar year
Participation is optional and available for benefits-eligible classified, management, faculty and part-time faculty employees.
You must complete a new form each calendar year you wish to participation. Enrollment does not roll over from one year to the next.
The election choice(s) you make for Section 125 can not be changed during the year except in the following circumstances: change in family status (marriage, divorce, death, birth or adoption); and/or change in FTE or employment status of employee or spouse.
It is an IRS "use it or lose it" program, so unused dollars are not refunded to you.
Health Care Expense Account (Flexible Spending Account)
Expenses incurred by employee, spouse or dependent children that are not covered under a medical, dental or vision plan. Examples: co-pay, co-insurance, deductible.
Dependent Care Expense Account
Expenses relating to dependent care that enable the employee to work. Examples: daycare, summer camps, after school care.
Annual Minimum and Maximum Contribution Amounts
Healthcare Flexible Spending – $240 minimum and $2600 maximum.
Dependent Care Account (daycare expenses) – no minimum and $5000 maximum if single or married filing jointly; $2500 maximum if married and filing separately.
College Contribution
The College contribution toward Section 125 does not apply toward the IRS maximum of $2600. Employees can contribute up to $2660 for 2017 and receive the College contribution in addition.
Contribution levels are based on health insurance enrollment tiers as follows:
Classified* – Employee Only: $670; Employee + One: $1340; Full Family: $1715
Management – Employee Only: $150; Employee + One: $250; Full Family: $300
Faculty/Part-time Faculty – Employee Only: $150; Employee + Spouse/Children: $250; Full Family: $300
Special Note: For this year, the health risk assessment is not required for classified and management employees.
*Ratification of contract pending.
Benefits Card Information
If your current benefits card is set to expire on 12/31/2016 and you've elected to participate in Section 125 for 2017, an updated card will automatically be sent in late December 2016.
Grace Period
If you have unused funds from 2016, expenses incurred through March 15, 2017 will automatically be paid from 2016 first. All 2016 reimbursement claims must be received by March 31, 2017. Any remaining balance(s) from 2016 will not be refunded to you after March 31, 2017.
Polestar Information and Links
- Reimbursement Claim Form
- Information Packet
- Summary of Benefits and Coverage (FSA)
- Plan Summary