Contents:

Eligiblility

Plan Provisions 

TSB Dos and Don'ts

Plan Contributions

How the TSB Plan Saves Money

Claims

Customer Service
Contacts

Forms:

Direct Deposit Authorization
/Termination form (PDF)

TSB Claim Form (PDF)

Dependent Care Flexible Spending Account Worksheet (PDF)

Healthcare Flexible Spending Account Worksheet (PDF)

See the Benefits Change Connection about making changes to your plan.

See also:

IU TSB Plan Booklet
  - 2007 (PDF)
  - 2008

IU TSB Plan 2008 Summary (PDF)

Eligible/Ineligible TSB Expenses (PDF)

Covered and non-covered over-the-counter items (PDF)

Nyhart Web site

Your TSB Account

Tax Saver Benefit (TSB)

This card is issued by M&I Bank FSB pursuant to license by MasterCard International. TSB-HRA card option TSB-HRA FAQ

Eligibility 

All Full-time appointed employees of Indiana University can elect participation in the Tax Saver Benefit Plan.

Plan Provisions 

The Tax Saver Benefit Plan allows eligible Indiana University employees to reduce out-of-pocket costs for eligible medical and dependent care expenses by using "tax-exempt" dollars. TSB dollars are never taxed by federal, state, local or FICA. Dollars usually paid in taxes end up in the employee's paycheck under the TSB plan.  Employees do not have to be enrolled in an Indiana University-sponsored health care plan to take advantage of these tax savings. 

Pre-Tax Premiums 

Eligible employees automatically receive preferential treatment for their premiums upon enrollment in medical, dental and/or Personal Accident Insurance plans.

Health Care Expense Reimbursement Account* 

• Any medical, dental or vision expense allowed by the IRS. Generally expenses must be incurred during the tax year or the two-month grace period (January and February) following the end of the plan year and submitted for reimbursement by April 15 of the following year.
   
• Maximum of $6,000 per year 
   
• Examples of IRS-allowed expenses
  • Deductibles and co-payments
  • Routine care/physical exams
  • Certain over-the-counter drugs and medicines
  • Transportation for medical services 
  • Weight-loss programs prescribed by a physician for a specific diagnosis
  • Stop-smoking programs 
  • Hearing aids and related expenses 
  • Prescriptions, including birth control pills
  • Dental care and orthodontia
  • Acupuncture 
     
• Examples of expenses not allowed by the IRS:
  • Individual or group medical premiums 
  • Expenses covered by an insurance or government program 
  • Cosmetic procedures 
  • Retin-A (unless for medical diagnosis), Rogaine and any other medicines prescribed for cosmetic purposes 
  • Expenses related to long-term care (personal and custodial care) 

Dependent "Day" Care Expense Reimbursement Account *

• Necessary expenses for day/evening care for dependents to allow employee and/or spouse to work during the plan year. 
   
• Includes cost of care for 
  • children under age 13 
  • other qualifying persons who need care due to mental or physical disabilities (older children, spouse, or older adults living in employee's home) 
     
• Maximum of $5,000 per year, or 
   
• Maximum of $2,500 per year if married and filing separately 
   
• Examples of expenses not allowed by the IRS:
  • Kindergarten
  • Overnight camp
  • Expenses paid but not yet incurred
• Claims must be submitted by April 15 following the end of the plan year.
  

*Notes for Expense Reimbursement Accounts 

• Employee must enroll in Expense Reimbursement Accounts each November during Open Enrollment to be eligible for benefits the following year. Employees will not be enrolled in reimbursement accounts without taking specific action for enrollment each year. 
• The employee's annual pledge amount is available for reimbursement from the first day of the plan year (money can be "withdrawn" faster than "deposited") 
• It is recommended that employees estimate conservatively: according to IRS regulations, any amount left over at the end of the year in a reimbursement account may not be returned to the employee nor moved between accounts.

TSB Dos and Don'ts 

• Do list the annual amount you want to contribute; don’t list the per-paycheck amount.
• Do estimate pledges based on expenses anticipated during the tax year (January 1 through December 31); don’t estimate on an academic year.
• Do list the amount of health expenses for you and your tax dependents in the Health Care Reimbursement Account section; don't include health expenses in the Dependent Care Account. Dependent care is for "day care" expenses, not health expenses.
• Do estimate your expenses conservatively; don't include expenses that you are unsure will be incurred.

Plan Contributions 

Indiana University covers the administrative costs of the TSB Plan.

Enrollment Provisions and Coverage Period 

The TSB Plan is offered on a tax year basis, and elections for participation in reimbursement accounts expire automatically at the end of each calendar year. The employee determines the annual pre-tax contribution, which is then deducted from salary and deposited directly into the respective TSB reimbursement account in the employee's name. The annual election is divided equally by the number of regular pay periods remaining in the year. 

Continuing employees must enroll each year during the Open Enrollment period in November for participation the following year in a reimbursement account.

New employees eligible for participation must complete the appropriate section of the benefit enrollment form within 60 days of the date of hire. Enrollment is not allowed during November and December for the current year.

Employees may change or stop the salary reduction agreement for participation in the Plan only when an IRS-defined change-in-status event is experienced. 

• A Change of Status event is a significant family or employment change, such as: marriage, divorce, death of a dependent, birth of a child, spouse's termination or commencement of employment, and termination or commencement of leave-without-pay. 

• Changes must be consistent with the event and must be requested in writing within 60 days of the date of the event. Forms should be submitted to the campus Human Resource office.

How the TSB Plan Saves Money 

Suppose an employee and his /her spouse require prescription drugs to treat high cholesterol, arthritis and depression. To maximize their savings, the couple requests that their prescriptions be filled with generic medications. Even with the cost savings of purchasing generic drugs, the couple’s copay for these drugs totals $480 per year.

The Tax Saver Benefit Plan can further maximize the couple’s savings. Normally, they would pay for their copays (which are out-of-pocket expenses) with after-tax income. However, using TSB, they would pay their prescription copays, and then receive reimbursement with tax-free income contributed from the employee’s paycheck.

Contributing pretax income to a TSB account is like getting a further discount on the drugs since they don’t have to earn as much money to pay for them. The money contributed to TSB reimbursement accounts by automatic salary reduction is not subject to federal, state, local, or FICA taxes. The amount of the savings depends on income, marital filing status, withholding allowances, and resulting tax rate. For example, a married employee with an annual salary of $34,000 with no allowances and no other deductions may save approximately 25.78 percent in taxes.

The following is an example only and is based on an annual salary of $34,000. Tax savings will depend on one’s individual tax rate. Tax savings really do add up.

Example:

Claims 

Claims for reimbursement may be filed at any time during the Plan year (January 1 through December 31) or within the 90 day grace period until April 15, following the end of the Plan year. 

Claims will be honored for services received from the date of your reduction agreement through December 31 of the Plan year or the grace period of January and February following the end of the plan year. 

If you have questions about allowable expenses or making a claim, contact The Nyhart Company Claim Center at 800-284-8412. 

Customer Service Contacts: 

The Nyhart Company 

For questions concerning qualified expenses, claims and reimbursement account balances: 
9320 Priority Way West Drive 
Indianapolis, IN 46240-1468 
Phone: 800-284-8412 
Fax: (888) 887-9961 
Web site: www.nyhart.com
E-mail:

To mail or fax claims: 
Attn: Claim Reimbursement 
The Nyhart Company, Inc. 
P.O. Box 80208  
Indianapolis, IN 46280-0208  
Fax: (888) 887-9961

Benefit plan information on these web pages is in a summary format and is not intended to replace actual plan documents. Indiana University reserves the right to amend or terminate all or any part of any benefit plan.