2020-2021 Benefits Guide rev 6.22.2021

You can receive reimbursement from your Dependent Care FSA for expenses that have already been incurred and only up to the dollar amount that has already been deposited into your account. If you have funds remaining at the end of plan year these funds will be forfeited. FSA Run Off Period September 30th is the last day to incur claims for the 2020-2021 plan year, and you must submit all claims by December 31, 2021. Reimbursement Process for FSA and HRA When you incur an eligible expense for you or your dependents, you may upload the Explanation of Benefits and/or receipts to the Proficient Portal or the Proficient Connect app. Claims are processed on a weekly basis and reimbursements are issued up to the available balance of your FSA and/or your Health Reimbursement Account. Monies will be reimbursed first from an employee’s FSA account then from the HRA account. To receive reimbursements for a covered expense under your health or dental coverage you must submit an Explanation of Benefits (EOB) issued from the health and/or dental insurance plan. For all other eligible expenses, you must submit documentation showing the following information: • Provider Name and Address While Proficient attempts to verify expenses automatically, there are times they cannot. The IRS requires proof that the paid amount is for a qualified expense, therefore you will be asked to verify the qualified expense(s) by submitting an explanation of benefits (EOB) or receipt of payment with service details and date of service. A reimbursement claim form can also be submitted. Since Proficient does not process checks, you will be required to submit your direct deposit information when you create your Proficient Connect account. Claims received by Proficient will be processed and any expenses eligible for reimbursement will be direct deposited into your personal banking account. Proficient MasterCard Employees will receive a MasterCard from Proficient to use when paying for eligible expenses (FSA Medical, FSA Dependent Care) and co-pays at the time of service. Register for Proficient Connect Through this online system, you can submit claims, add receipts, view your account details, access forms, and get answers to frequently asked questions anytime from anywhere. To register for Proficient Connect online go to www.proficientbenefits. Select Register. When creating your account, your Employee ID number is your SSN. Download the Proficient Connect App • Patient Name • Date of Service • Description of service or supply • Amount of service or supply NOTE - A “paid receipt” is not proper documentation.

You can also download the Proficient Connect App from the App Store or Google Play. The app makes it convenient to keep track of your reimbursements and makes it easy to submit EOB’s. Simply take a photo or a screenshot and upload it directly to the app!

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