Employee Security, Inc. ESI Flexible Benefits

Unreimbursed Medical Expenses

Any medical expenses that you pay for that are not covered under any of your medical insurance policies can be paid with pre?tax dollars under The Flexible Benefit Plan through this spending account. Examples of these expenses are:

  • Medical and dental insurance plan deductibles.
  • Out-of-pocket expenses not covered by your health insurance plan, including the co-insurance.
  • Such expenses as birth control pills, braces, chiropractors, crutches, dental fees, prescription drugs, eye glasses or contacts, insulin, routine physical exams, physician prescribed weight loss or smoking cessation program, wheelchairs, among others.
  • Once you've estimated how much you expect to spend for these expenses, up to whatever maximum your plan allows, you then divide that figure by the number of times you are paid during the plan year. This gives you the amount that you will reduce your salary by each paycheck.

    During the year, whenever you incur an eligible expense, you submit a claim form to our claims processor along with suitable documentation to Employee Security, Inc., 5565 Sterrett Place, Suite 300, Columbia, MD 21044-2608. Suitable documentation must include the date of service, amount charged, service performed. In general, a copy of a doctor's bill or a copy of an explanation of benefits from your insurance company will suffice. You may be reimbursed up to the amount that you have annually elected. Please Note: Expenses must be incurred during the plan year for you to be reimbursed. When you pay for, or are formally billed for services, does not matter.

    The following is a partial list of eligible expenses under the plan. PLEASE NOTE: Premiums for health insurance policies ARE NOT reimbursable under this plan, but may be eligible under the PRIVATE INSURANCE REIMBURSEMENT ACCOUNT.

    PARTIAL LIST OF ELIGIBLE EXPENSES

    Acupuncture / Alcoholism Treatment / Ambulance Hire / Artificial Limes / Artificial Teeth / Birth Control Pills / *Braces / Braille Books & Magazines / Car Controls for the Handicapped / Care for Mentally Handicapped Children / Chiropractors / Christian Science Practitioners Fees / Co-Insurance / Contract Lenses / *Cosmetic Surgery IF MEDICALLY NECESSARY / Cost of Operations & Related Treatments / Crutches / Medical Insurance Deductibles / Dental Fees / Dentures / Diagnostic Fees Drug and Medical Supplies Prescribed by Physician / *Electrolysis / Eyeglasses, Including Exam Fees / Fee for Practical Nurse / Fees for Healing Services / *Hair Transplants / Handicapped Person's Special Schools / Hearing Devices and Batteries / Home Improvements required by Medical Conditions / Hospital Bills / Hypnosis for Treatment of an Illness / Insulin / Laboratory Fees / Laetrile by Prescription / Lead-Based Paint Removal (for children with lead poisoning) / Life Fee for Retirement Home for Medical Care / Medical Information Plan / Nurses' Fees / Obstetrical Expenses / Operations / Orthodontist Fees / Orthopedic Shoes / Oxygen / Physician Fees / *Physician Recommended Swimming Pool Equipment costs and maintenance / Psychiatric Care / Psychologist Fees / Special Home for mentally handicapped person / Routine Physicals & other non-diagnostic services or treatments / Seeing Eye Dog & Its Upkeep / *Smoking Cessation Program prescribed by a physician / Special Diets / Special Education for the Blind / Special Plumbing for the Handicapped / Sterilization Fees / Surgical Fees / Telephone & Television (if special for the deaf) / Therapeutic Care for Drug & Alcohol Addiction / Therapy Treatments / Transportation Expenses primarily for the rendering of medical service, such as railroad fare to a hospital or cab fare in pregnancy cases. / Tuition at Special School for the Handicapped / Tuition Fee (part), If college or private school furnishes breakdown of medical charges. / Vitamins by prescription / *Weight Loss Program (Only the cost of the program, not the cost of the food) / Wheelchairs / Wigs / X-Rays /

    *NEED PHYSICIAN STATEMENT VERIFYING MEDICAL NECESSITY.

    This list is compiled from Paragraph 7003, CCH Federal Tax Guide Report and complies with IRC Section 213.

    Back To Flexible Spending Accounts