Entertainment Industry Flex Plan

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ACA Frequently Asked Questions (FAQs)
Affordable Care Act (“ACA”) and how it affects your Flex Plan Participation If you are covered by any type of group insurance (not just from the Flex Plan), there are no adverse affects of the ACA. If you have or are considering an Exchange or Individual Policy, please review the questions and answers below. For a comparison of Flex Plan group coverage and an Exchange or Individual Policy please make sure to review: www.flexplan.com/aca-compare
Questions and Answers
Only participants who choose to be covered by an individual policy (a policy that you obtain as an individual directly from an insurance company) or participants who elect coverage through one of the exchanges created by the ACA. Participants who are enrolled in “group” coverage under any of the Flex Plan insurance contracts, covered by their spouse, another employer or union’s plan will not be affected.
No.
Participants may use account balances from employer contributions posted PRIOR TO 01/01/2014 for participant and dependent out-of-pocket medical expenses provided the participant has current insurance information (group, individual or exchange) on file with the Plan (Grandfathered Balance Rule). Individual and Exchange premiums incurred after 01/01/2014 cannot be reimbursed from any employer contributions.

Yes. The ACA requires that in order to use contributions made by your employer to the Flex Plan you must be enrolled in “group” health coverage. If you are not enrolled in a “group” health insurance plan, you will automatically be “opted-out”. Employer contributions (if any) will continue to bank in your account and your account will continue to be subject to administrative fees. You will have access to the employer contributions when you resume “group” coverage. You cannot use employer contributions for reimbursement of premiums or reimbursement of out-of-pocket medical expenses when “opted-out” (not covered by “group” insurance).

If you are covered by an individual policy, effective 1/1/2016 you are no longer eligible to use voluntary pre-tax payroll withholdings for premium reimbursement. You cannot use the contributions made by your employer for premium reimbursement or reimbursement of out-of-pocket medical expenses.

Yes. The ACA requires that in order to use contributions made by your employer to the Flex Plan you must be enrolled in “group” health coverage. If you are not enrolled in a “group” health insurance plan, you will automatically be “opted-out”. Employer contributions (if any) will continue to bank in your account and your account will continue to be subject to administrative fees. You will have access to the employer contributions when you resume “group” insurance. You cannot use employer contributions for reimbursement of premiums or reimbursement of out-of-pocket medical expenses when “opted-out” (not covered by “group” insurance). In addition, you cannot use voluntary pre-tax payroll withholdings for reimbursement of premiums for coverage purchased through an exchange.

No. You will still be able to be reimbursed for your Medicare and supplemental Medicare Premiums from your Flex Plan account as well as out-of-pocket medical expenses. Here is a link to the Medicare Q&A page regarding the ACA:

http://www.medicare.gov/about-us/affordable-care-act/affordable-care-act.html
No. You will still be able to be reimbursed for out-of-pocket medical expenses. Here is a link to the Veterans Administrations Q&A page regarding the ACA:

http://www.va.gov/health/aca/FAQ.asp
No. In this case you could get reimbursed for your out-of-pocket expenses, but not theirs. Reimbursement of out-of-pocket expenses is only available to participants and dependents covered by a group insurance plan. (See question below)
Yes. In this case you could get reimbursed for their out-of-pocket expenses, but not yours. Reimbursement of out-of-pocket expenses is only available to participants and dependents covered by a group insurance plan. (See question above)
They may be used for dental, vision or disability premiums (group or individual) or Flex Plan life insurance premiums (group only). Any unused employer contributions will roll-over to the next year, they are not lost.
No. In order for the Flex Plan to reimburse premiums or out-of-pocket expenses, you must be enrolled under a “group” health insurance plan. If you are not enrolled under a “group” insurance plan, you will be “opted-out”. Your account will remain with the Flex Plan and will continue to be subject to administrative fees.
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