Polestar Benefits, Inc.

What is a Cafeteria Plan?

A Cafeteria Plan is a written plan offered by an employer and many times maintained by a Third Party Administrator, like Polestar Benefits.  The most common of these plans are Health Care Flexible Spending Accounts (FSA), Dependent Care Accounts (DCAP), Parking/Transit Commuter Benefits (TRN) and Premium Only Plans (POP).  These plans allow employees to pay for certain non-reimbursed health care expenses on a pretax basis. 
  • 2 Business Day Claim Turnaround
  • No Minimum Monthly Dues
  • Benefits Card Available
  • 24/7 Online Access
Picture
Picture

 

Picture

How It Works

  1. Employees sign up for the plan and elect their anticipated out-of-pocket health care, dependent care and/or transit expenses for the year.
  2. Each paycheck, their election is deducted on a pretax basis and is available for reimbursement.
  3. As employees incur health care and dependent care expenses, they submit a Reimbursement Request Form with required supporting documentation.
  4. Within two business days, a check is mailed directly to their home address (as long as claim is approved and funding is available).  Employees can also opt for Direct Deposit (if employer approved), in which case reimbursements are released every Tuesday and Friday.
Examples Include:
     Out-of-Pocket Medical Expenses (not covered by Insurance)
            • Health Insurance Deductible and Co-Insurance
            • Prescription and OTC Drug Costs (Note: Doctors Prescription required effective 1/1/11)
            • Dental and Vision Expenses
            • Non-Covered Medical Expenses
     Dependent Care Expenses
            • Child Care (age 12 and under)
            • Disabled Dependent Care
     Transit/Commuter Expenses
            • Riding in a commuter vehicle between the employee home and workplace
            • Transit pass
            • Qualified parking garage
            • Qualified bicycle commuting reimbursement
For a complete list of Eligible Expenses, please visit IRS.gov

Benefits Card

The Benefits Card makes the reimbursement process simple.  Instead of the member paying out-of-pocket expenses and waiting for reimbursement, the transaction is processed at the merchant counter.  Depending on the benefit accounts offered by the employer, the card may be linked to a:
    •   Flexible Spending Account (FSA) 
    •   Dependent Care Spending Account (DCAP)
    •   Health Savings Account (HSA)
    •   Transit Spending Account (TRN)
Picture
The Benefits Card can be used at both health care (doctors, dentists, eye care facilities and other locations that sell only medical services/products) and non-health care merchants (any retailer who may carry health care products: grocery stores, mass merchandisers and pharmacy stores).

Ease of use

Beyond the convenience of the Benefits Card, where members do not have to pay out-of-pocket of expenses and simply pay the merchant right away, we can make card transactions even easier with auto approvals.

Auto approvals allow our system to know what amounts can be approved without requiring more documentation from the member. Whether it's only for copays, amounts below $250 or all amounts processed through the card - we can make transactions even easier, more convenient and not require additional documentation.

If you have any questions about how this works, please let us know.

Important documentation about Cafeteria Plans

PPACA change to over-the-counter drugs and the use of Benefits
Rev. Rul 99-7 RE: what transit expenses are eligible
Publication 969 from IRS website
Publication 15b
Publication 503 RE: Dependent Care
Publication 502 RE: What expenses are includible?
IRS Code 152 RE: Dependent Definition