CAFETERIA PLAN INFORMATION
A Section 125 Cafeteria Plan is simply a tax savings plan which allows participating employees to deduct certain expenses from gross earnings before the computation of federal, state, and social security taxes. Under our Plan there are three (3) options in which you may participate.

CURRENT DEDUCTIONS ELIGIBLE TO PRE-TAX
Insurance:
Option 1. BC/BS, Health, State Life, Delta Dental, Superior Vision, Colonial Accident, Cancer and ICU Aflac Cancer, Accident and Hospital Advantage, Allstate Gap and Accident
Post Tax Insurance Products: Colonial STD, Aflac STD, Cigna LTD and STD, NY Life, Transamerica and Allstate
Life

Flexible Spending:
Option 2. Dependent Care Expenses
Option 3. Unreimbursed Medical Expenses

OPTION 1. INSURANCE
When making your on-line election, simply indicate that you wish to have your premiums pre-taxed under our plan. Payroll will make the necessary adjustments and your eligible premiums will be deducted tax-free.

OPTION 2. DEPENDENT CARE EXPENSE
If you have dependents that require care while you and your spouse work, participation in this part of the plan can save taxes by pre-taxing the expense. Simply estimate your dependent care expenses for the current plan year, up to a maximum of $5,000 per calendar year, ($2,500 if married filing a separate return.) Your election will be divided by the number of pay periods in the plan year and deducted tax free. For more information log on to: www.sabcflex.com/content/dependent-care

OPTION 3. UNREIMBURSED MEDICAL EXPENSES
If you have medical expenses which you have to pay out of your own pocket, such as; your medical deductibles, co-insurance, dental expenses, eye care expenses, etc., you may save valuable tax dollars by pre-taxing these expenses. To participate, you must estimate the out-of-pocket medical expenses you will incur during the plan year up to a maximum of $2,750. Your plan year election will be divided by the number of deductions in the plan year and deducted tax free. After eligible expenses have been incurred, simply submit proof of the expense with a reimbursement form and you will be reimbursed up to the amount you have requested, not to exceed your annual
election. Please go to (www.sabcflex.com/content/eligible-medical-expenses ) for more information on eligible expenses. Expenses may be for you, your spouse or children under age 27. Your plan offers a 2 ½ month grace period for participants to incur expenses. Therefore, with the extension you will actually have until March 15, 2022 to incur your expenses. This extension applies to URM only.
All services rendered for unreimbursed medical should be on the list of eligible deductible medical expenses. Should you have a medical expense not listed, please feel free to contact SABC or see a representative during the enrollment.
IMPORTANT NOTE: You must participate in the Unreimbursed Medical portion of the plan for the whole plan year. Your total election is available to you anytime during the plan year when you incur an expense(s). Should you terminate anytime during the plan year, in lieu of Cobra; your remaining election will come from your last paycheck. You will have until the end of the plan year to incur your expense(s) and a sixty (60) day run out period after the plan closes to request reimbursement for qualified expenses.

All elections made under your flexible benefit cafeteria plan are irrevocable unless a Status Change occurs. Examples of Status Changes are – marriage, divorce, birth, death, adoption or, a change of your spouses’ employment. Election under Dependent Care and/or Unreimbursed Medical should be conservative. Any monies not claimed by the end of the plan year or at least sixty (60) days after the close of the plan year, will be forfeited. All expenses must be incurred within the benefit period listed above.

CLAIMS PROCEDURES
To receive reimbursement for expenses incurred during the plan year you must submit a Claim Form (Request for Reimbursement) to Southern Administrators and Benefit Consultants, Inc. (SABC) Attached or along with the claim form, you must provide a receipt from the third party provider for each expense. An Explanation of Benefits from your insurance provider is your best receipt and may be required. For more information log on to: https://www.sabcflex.com/content/claim-procedures.

ON-LINE ENROLLMENT INSTRUCTIONS
Open on September 16, 2020 and will close on October 31, 2020

Login at: www.sabcflex.com/content/sabcelect-on-line on or after September 16, 2020 or just go to www.sabcflex.com and click on enroll online.
Enter your social security number (no dashes) as your employee ID, and your six digit date of birth as your password (mmddyy).
Step 1. Review and revise any personal information that is incorrect. Follow the instructions to the next page.

Step 2. Review your current information. If correct and you have no changes, continue to the next page.
If you wish to enroll in the dental or vision, click the enroll button next to the product and follow the instructions. Complete the online application. Once complete, you will return to the Cafeteria Plan enrollment. Keep in mind when enrolling your signature will always be your social security number. To cancel any supplemental insurance product, click the cancel coverage button and complete the online form. To review benefits under the plan, click on the name of the products that are highlighted in blue.

Step 3. Make your Flexible Spending election. If you are electing to participate in Flexible Spending for the first time, please have your direct deposit information available to enter online.

Step 4. Review the summary of your election, if correct, proceed to the next step. If incorrect, click the back button.

Step 5. Read the plan provisions, acknowledge that you understand, and sign using your SS#. Your enrollment is complete.

Please print or email a copy for your records and click done.

Click Here: Delta Dental

Click Here: Superior Vision

If you have questions or trouble with online enrollment, contact Southern Administrators and Benefit Consultants Inc. at 601-856-9933