| Q: | Will I receive any type of dental or vision insurance card? | | A: | No. If your provider would like to call the Fund office to verify your eligibility, the office number is 504-455-7261 and the office hours are 8:00 a.m. to 4:00 p.m. Monday - Friday. |
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| Q: | May I schedule an appointment with a dentist of my choice? | | A: | Yes. You may go to any dentist locally, out-of-state or even out of the country. You may also change dentists any time you wish. |
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| Q: | What if I pay my dentist in full, will you reimburse me? | | A: | Yes. Unless you have signed the claim form authorizing payment directly to the dentist, you will be reimbursed based on our benefit plan. |
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| Q: | Are there limitations on the number of times I may go to the dentist? | | A: | Not really. Each covered individual has a $1500 annual maximum for dental benefits and $1,000 lifetime orthodontic benefit. Please refer to the Summary Plan Description for limitations on the number of visits and time guidelines for certain procedures. |
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| Q: | Does the Fund require a pre-treatment estimate for extensive dental work? | | A: | No. However, it may be to your benefit to submit a pre-treatment estimate if you are planning to have major work such as, periodontal surgery, a bridge or implants. These types of procedures must be reviewed by the Fund's dental consultants and this will assure you if the procedure will be covered, not covered or payable at an alternate benefit. |
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| Q: | Is TMJ covered? | | A: | No. TMJ (TemporoMandibular Joint) is considered a medical condition. You may want to check with your health carrier to see if they cover anything associated with TMJ. |
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| Q: | Is removal of wisdom teeth covered? | | A: | Yes. This is covered at 80% of our reasonable and cutomary fee. Also, if the wisdom teeth are impacted, please have your dentist file with your hospitalization plan first. Once your hospitalization carrier has processed the claim, attach a copy of the hospitalization's Explanation of Benefits to a copy of the dental claim and submit it to the Fund office for processing. Many of the hospitalization plans cover impacted wisdom teeth. |
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| Q: | How often can I schedule an eye examination? | | A: | An eye examination can be schedule once every 12 consecutive months. |
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| Q: | How may I drop my dependent coverage for dental and vision benefits? | | A: | There are few things that must be determined to respond to this. First, do you have your benefit pre-taxed. If so, unless you have a qualifying event, such as a divorce or reduction in salary, you will not be able to drop the coverage until you complete a revocation form during open enrollment at your school location in September or October. The coverage would drop effective January 1. If you do have a qualifying event that would allow you to drop your coverage prior to the first of the year, you must call the Payroll Department within 30 days of the qualifying event at 349-7621 and request a revocation form. If you do not have your benefit pre-taxed, you may write the Fund office at any time and request that your dependent coverage be dropped. This would go into effect the first of the month following receipt of your letter. These same rules apply for changing dependent coverage from family coverage to spouse only or children only or from spouse or children only to family coverage. |
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| Q: | When must I enroll in the Flexible Spending Account plan? | | A: | There is only one open enrollment period each year. That period is announced each year by Board of Trustees. No enrollments will be accepted during the year, except for those of new employees who can enroll during their Waiting Period. Enrollment forms can be downloaded from Documents on the left side of our webpage or you may call the Fund Office. |
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| Q: | What is the advantage of participating in the FSAs? | | A: | Immediate tax advantages
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| Q: | What is the "use-it or lose-it" provision? | | A: | It is a provision required by law. This is a requirement that any money left in the account at the end of the Plan Year must be forfeited. You have until December 31 after the end of the Plan Year to file for reimbursement of expenses incurred during the Plan Year. By planning carefully you can avoid "losing" contributions. |
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| Q: | Any suggestions on how to manage my paperwork for filing my Health Care FSA claims? | | A: | One suggestion would be to save your receipts and file them periodically. As the end of the Plan Year draws near, check to see how much you have used of your election and the balance remaining so you can use your money before the end of the Plan Year and/or grace period. |
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| Q: | Can I receive reimbursement for medical care expenses for all of my dependents? | | A: | Yes. If the medical care expense is for a person whom you claim on your federal income tax return and your child is under 24. Children between 19 and 23 must be in school full time and student verification is required. |
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| Q: | Do I have to pay taxes on the reimbursements from my flexible spending accounts? | | A: | No. |
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| Q: | What happens if I open an FSA and later leave my job with the school system? | | A: | Contributions will cease the day following your last work day. You will then have an option to continue participation in your medical care account but not the dependent care account. However, if you continue medical care coverage, your contributions are made on an after-tax basis thus giving you no tax advantage in continuing coverage. You can continue to file claims for reimbursement of eligible medical care expenses incurred prior to leaving your job. If you have a dependent care account, you can continue to receive reimbursement for eligible dependent care expenses incurred during the Plan Year from the balance remaining, if any, in your dependent care account. However, you will not be able to contribute any further amounts to this account and may not elect to continue self-pay coverage for this account. For both accounts you have until December 31 after the end of the Plan Year to file for reimbursement of eligible expenses. There are additional provisions in case of death and also transfer to a job classification not eligible for JFT Health and Welfare Fund coverage. Refer to the JFTH&W's Summary Plan Description for more details. |
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Get in-depth information here.
Summary Plan Description