Benefits Coach
F O R L A K E L A N D H E A LT H T E A M M E M B E R S
Winter 2016
Taxes and Your
Flexible Spending
and Health Savings
Accounts
Tax season is quickly approaching and you may have questions
on how your flexible spending and/or health savings account
may impact the filing of your taxes.
If you have a flexible spending account, nothing is required.
The money deducted from your paycheck is not subject to
income tax. Any medical, dental, vision expenses that you were
reimbursed for using your flexible spending account should
not be claimed on your taxes.
If you have a health savings account, you will receive 2
documents from Fidelity to assist you when filing your taxes.
Form 5498-SA will show the amount that was withheld from
your paycheck, pre-taxed and placed in your health savings
account. The second document, Form 1099-SA will show the
total amount disbursed from this account. When you file your
taxes, you will be asked, “Did you have a high deductible health
plan?” “Did you contribute to a health savings account?” “Did
your employer contribute to your health savings account?”
“How much was disbursed from your health savings account?”
You will use the documents from Fidelity to fill in the amounts
contributed and the amounts disbursed. This is how the
IRS will determine if any funds were used for non-qualified
expenses and if so, those amounts will be subject to income
tax and penalties.
Fidelity mailed forms at the end of January but are also
available to view and print on their website. Simply log in to
your Fidelity account and look for the “Statements” section.
If you have questions or concerns, please consult your
tax advisor.
Money Left
in Your 2015
Flex Spending
Account?
If so, you may incur expenses through
March 15, 2016 and be reimbursed from
your 2015 Flexible Spending Account.
The deadline for submission of these
claims is June 15, 2016. If the two and a
half month extension period has passed
and there is still money left in your 2015
account, the money will be subject to the
“use-it-or-lose-it” rule, and the balance will
be forfeited as it has always been done in
the past.
Coordination of
Coverage For Injuries
Arising Out Of
Automobile Accidents
Did you know that your health plan contains a special
coordination rule regarding your automobile insurance and the
health plan? Your automobile insurance plan (which is required
by law in the state of Michigan) is required to pay first, and your
Lakeland Health Plan pays second. Once you’ve used all of the
benefits available through your automobile insurance plan, the
Lakeland Health Plan will begin paying for covered charges.
This is in reference to the health benefits provided by both
plans only.
According to the Office of Financial and Insurance Regulation
for the state of Michigan (Insurance Counselor – Insurance
Consumer Information Sheet dated 09/12), “No-Fault Insurance
is required by law in Michigan. Every owner of a car must
buy certain basic coverage in order to get license plates. It is
against the law to drive or let your car be driven without
no-fault insurance”.
The basic No-Fault Policy you must buy has three parts: (1)
Personal Injury Protection (PIP), (2) Property Protection (PPI),
and (3) Residual Liability Insurance - Bodily Injury and Property
Protection. It’s the Personal Injury Protection (PIP) that
coordinates with your Lakeland Health Plan coverage and
must pay first.
If you fail to purchase the auto insurance coverage required
by law AND the Lakeland Health Plan ends up paying for your
medical expenses when the auto insurance coverage (PIP) you
were supposed to buy would have, the Lakeland Health Plan
has a legal right for reimbursement.
So, please be sure you have the proper coverages in place to
protect you and your family from financial hardship in the
event you are involved in an automobile accident requiring
medical treatment.
Out-Of-Network
Care
If you need to see a Physician for services
that are not provided by Lakeland or you are
being referred outside of Lakeland by your
physician, you and your physician are required
to complete the Out-of-Network referral form
and receive approval prior to services being
rendered. Referrals must come from a Lakeland
Specialist. Approved services will be paid
at 70% of the allowed amount. You may be
responsible for the difference between what was
billed and what was paid. Out of network office
visits have a $55 co-pay. The Out Of Network
Referral form may be found on the Lakeland
Benefit Center. For questions, please e-mail
[email protected].
Remember, any unapproved services provided
outside of the Lakeland network are not covered.
For students that are away from home going
to college, any health care services should be
provided at Lakeland when possible, but when
occasionally a child that is away at college will
need medical attention. If this occurs, you will
need to complete an out of network referral
form and fax it to the number on the form. If it
is determined that extensive/ongoing care may
be needed, your child will be re-directed back to
Lakeland for additional medical services. Please
be aware that wellness/preventive care will not
be covered out of network, so it is important to
schedule these visits when your child is home
on school breaks.
Shingles
Personal Contact Information
Vaccines
at the
Pharmacy
Shoppe
Our benefits/payroll system has a great feature making it very easy to add, remove,
and update your Personal Contacts. This includes your spouse and children you
have listed as dependents on any of our insurance plans as well as individuals listed
as beneficiaries on your life insurance plan(s).
It is recommended that you have at least 1 person designated as your “emergency
contact” which can also be added in this same section.
For the convenience of our
associates, the shingles
vaccine is being administered
at the Pharmacy Shoppe at the
Center for Outpatient services.
Three of our pharmacists have
been certified to administer
the vaccine. Call for an
appointment at 556-2888.
Appointments are preferred
but not mandatory. A
prescription is needed in order
to receive the vaccine. The
Pharmacy Shoppe is opened
Monday through Friday from
8:00 am to 5:30 PM. The
shingles vaccine is covered
at 100% with no copy under
Lakeland’s medical plan.
Everyone is encouraged to review their Personal Contact information at least once
a year. If you have changes to your personal status, such as marriage, divorce, birth,
death, please be sure to update this information as well.
Below are screen shots to guide you through the process:
Click on the BENEFITS option then select PERSONAL CONTACTS
To add a new contact, click ADD. The screen below is what you will see.
If you need to update current information, you will highlight the line of the
person to be revised.
Keep in mind if you need to make any changes to your benefit plans as a result
of a personal status change, you do need to contact your Benefits Coordinator in
Human Resources.
1095-C Form
In 2016 the Patient Protection and Affordable Care
Act (ACA) requires certain employers to provide
tax forms to their employees to help the employee
file their individual income taxes. The ACA also
requires most taxpayers to certify on their individual
tax returns that they had minimal essential health
insurance coverage.
Under the rules of the ACA’s “employer responsibility
requirement,” Lakeland Health is a large employer
that offers at least one plan that meets the definition
of Minimum Value. Lakeland’s plan is considered
affordable to associates or their dependents under
one of the affordability safe harbors.
Employers with a group health plan have varied
reporting requirements to both the Internal Revenue
Service (IRS) and to employees, depending on the
size of the employer and how their group health
plan is funded.
offered or enrolled in the Lakeland group health
plan. The 1095-C is a way of documenting the health
insurance that team members were offered or
enrolled in for 2015.
The due date for providing the 1095-C form has been
extended by the IRS to March 31, 2016. Lakeland
team members will receive the form in the mail by
this date.
For 2015 only, if you file your income taxes before
you receive your 1095-C form, you will not be
required to amend your tax return once you have
received your form.
The IRS form(s) that you receive should be kept
with your annual tax documents, forms, and other
paperwork, such as your W-2.
Please contact your tax advisor if you have any
questions about your individual tax return.
Based on these obligations, Lakeland team members
will receive a 1095-C form in the mail if they were
Karen Knuth
Manager, Total Rewards
[email protected]
(269) 983-8383
Bobbi Mai
Benefits Coordinator
[email protected]
(269) 687-1469
Team Members with last names A - L
Sheryl Paloucek
Benefits Coordinator
[email protected]
(269) 687-1860
Team Members with last names M - Z
Kristina Sanderson
Disability & Leave of Absence
Coordinator
[email protected]
(269) 985-4584