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My Benefits. My Life.

Participant Guide to the

2011 Dependent Care

Reimbursement Account

Administered by

WageWorks

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Table of Contents

Dependent Care Reimbursement Account

Contributions and Contacts. . . 4

Managing Your Account . . . 5

How to File a Claim . . . 6

Dependent Care Pay My Provider . . . 7

Proof of Expense . . . 8

Dependent Care Reimbursement Account Rules . . . 8

What’s Covered by Your Dependent Care Reimbursement Account . . . 10

Appendix: Sample Dependent Care Documentation . . . 11

No part of this guide is intended to provide tax or legal advice. Consult a professional advisor regarding your personal situation.

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Welcome to the Dependent Care

Reimbursement Account

By setting aside pre-tax money from your pay into the Dependent Care Reimbursement Account, you may later repay yourself for eligible expenses incurred in calendar year 2011.

Because your contributions are deducted from your pay before federal income, state income, and Social Security taxes have been withheld, you save on taxes.

We hope this guide helps you understand how to use and manage your Dependent Care Reimbursement Account. Additional information is available on the Duke Human Resources website at www.hr.duke.edu/reimbursement.

Contacts

If you have questions that are not addressed in this guide or on the website, please contact: WageWorks Phone: 877-924-3967 Fax: 877-353-9236 Mailing Address: Claims Administrator PO Box 14053 Lexington, KY 40512

Remember: Completed claim forms and supporting documentation for calendar

year 2011 expenses must be postmarked, faxed or submitted online to WageWorks by April 15, 2012.

Be sure to provide your Duke Unique ID if asked or prompted to provide your Social Security number. If you provide your social security number, your account will not be recognized.

My Benefits. My Life.

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Online Claims Options

WageWorks offers the convenience and option to complete your Dependent Care Pay Me Back (PMB) claim form online when you log on to your WageWorks account at www.hr.duke.edu/reimbursement. Once you have entered your claim information, you can print the form and mail or fax it to WageWorks with the receipts, or upload a scanned copy of your receipts to the WageWorks system for

processing. You can also attach your claim form and receipt(s) to an email sent to

paymeback@wageworksclaims .com. Attachments must be no larger than 5MB.

You are encouraged to establish your online account at

www.hr.duke.edu/reimbursementand provide an email address in your profile so that WageWorks can communicate with you regarding time-sensitive information like claims notification and account updates.

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Dependent Care Reimbursement

Account Contributions and Coverage

Maximum Contribution

Participating employees may contribute up to $5,000 per year to the Dependent Care Reimbursement Account. However, if you use a Duke-contracted facility, such as the Duke Children’s Campus, and receive a subsidy, the amount that you can contribute to the Dependent Care Reimbursement Account is reduced dollar-for-dollar. Your total contribution cannot be greater than your earned income or your spouse’s earned income, whichever is lower. This means if your spouse’s salary is $4,000 and your salary is $30,000, the most you can contribute is $4,000. If your spouse has no earned income, you are not eligible for a Dependent Care Reimbursement Account. (There are special rules if your spouse is a full-time student or is disabled.)

If both you and your spouse have Dependent Care Reimbursement Accounts, your total combined contribution limit is $5,000.

If your salary is above $110,000, federal law may require your dependent care election to be readjusted based on the results of discrimination testing. If you are affected, you will be notified during the plan year of any necessary adjustment to your contribution amount.

Who is covered

Dependents are defined differently between the Health Care Reimbursement Account and the Dependent Care Reimbursement Account. For the Dependent Care Reimbursement Account, dependents are:

Children up to their

13th birthday

Other individuals

whom you claim as a dependent on your federal income tax return (spouse, parent or child) regardless of age, who live with you and are incapable of caring for themselves.

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If you are Divorced or

Legally Separated

If you are divorced, legally separated, or have lived apart from your spouse during the last six months, the parent who is able to claim your child as a dependent on his or her tax return is the custodial parent. This parent can be reimbursed for the child’s day care expenses through the Dependent Care

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Manage your dependent care account and get help conveniently online or by phone.

You can do all this online anytime:

View your account activity and balance

Check status of claims and payments

Download claim forms

Upload claim forms, receipts and other documentation on the WageWorks website, or send them via email

Update your contact information

Request Pay My Provider payments (see page 7 for details)

If you have not yet registered:

Complete the simple online registration process: 1. Go to www.hr.duke.edu/reimbursement

2. Click on “Login to Your Personal Account” and enter your Duke NetID and password*

3. Enter the information requested

4. Confirm or update the contact and address information in your profile 5. Complete banking information if you want checks to be direct deposited

into your bank account

6. Review the User Agreement and confirm your acceptance

If you have already registered:

Go to www.hr.duke.edu/reimbursementand click on “Login to Your Personal Account.” Enter your NetID and password to view your online account, check the status of payments, claims, and reimbursements and upload claim forms directly to WageWorks.

Access your Statement of Activity anytime online at

www.hr.duke.edu/reimbursement. Activity statements include your current account balance and recent payments, claims, and reimbursements.

If you don’t have Internet access:

Call WageWorks at 877-924-3967. WageWorks’ automated voice response system can assist you around the clock. Customer service representatives are available Monday through Friday, 8 a.m. – 8 p.m. EST. Be sure to provide the last 4 digits of your Duke Unique ID when prompted to provide the last 4 digits of your Social Security number. WageWorks has no record of your Social Security number and will not recognize your account if you enter the last 4 digits of your Social Security number.

Managing Your Account

Important Tips

for 2011

䡵 You will need to provide your Duke Unique ID if asked or prompted to provide your Social Security number. If asked to provide the last 4 digits of your Social Security number, provide the last 4 digits of your Duke Unique ID. If you provide your Social Security number, your account will not be recognized. 䡵 You must file a separate

claim form for Health Care Reimbursement Account expenses than for Dependent Care

Reimbursement Account expenses. Customized claim forms are available at www.hr.duke.edu/ reimbursement. These customized forms are not available on the WageWorks website. 䡵 If a claim requires

additional information, you must resubmit the entire claim along with proper documentation. Each claim is reviewed on a claim-by-claim basis.

䡵 Day care claims must include the provider’s Tax Identification Number (TIN) or SSN to be approved. 䡵 Each expense must be

reported on a claim as an individual line item. Do not date span or “lump” similar charges.

䡵 To set up direct deposit for speedy reimbursement into your checking account, go to www.hr.duke.edu/ reimbursement, login to your personal account, and complete the necessary information regarding your bank account.

* Your Duke NetID should not be confused with your Duke Unique ID. Your NetID identifies you to systems and services provided through the Duke computing network. If you do not know your NetID or password, university employees can contact the Duke OIT Help Desk at 919-684-2200, and health system employees can contact the DHTS Help Desk at 919-684-2243.

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Dependent Care Pay Me Back

WageWorks’ claim filing service is called Dependent Care Pay Me Back. You will see references to this throughout the Duke HR website and other materials.

Through the Dependent Care Pay Me Back service, you can get reimbursed from your Dependent Care Reimbursement Account for eligible products and services you pay for out of pocket by submitting a claim form.

When to Use Pay Me Back/File a Claim

Some expenses are easier to pay for first, and then get reimbursed. For example:

When your provider requires you to pay in advance (before the first of the month during which services will be provided). You may pay for the services as required, and then file your claim after you have received the service.

Your provider wants to get paid other than monthly.

Your expenses vary month to month.

How to Use Pay Me Back/File a Claim

Pay your dependent care provider as you usually do and save your detailed receipt (or have your dependent care provider sign your claim form).

Complete a Dependent Care Pay Me Back form. You can download the form at www.hr.duke.edu/forms/reimbursement-dependent.php.

You may file your Pay Me Back claim in different ways:

1. FAX: Print off the filled out Pay Me Back form and fax it, along with appropriate proof of expense, to 877-353-9236.

2. MAIL: Complete or print off the filled out Pay Me Back form and mail it, along with appropriate proof of expense, to: Claims Administrator, PO Box 14053, Lexington KY 40512

3. ONLINE: Go to www.hr.duke.edu/reimbursementand log into your Account.

Select the online claim form.

Fill in all the information requested and submit.

Scan receipts and other supporting documentation in a file that is no larger than 5MB (acceptable formats are TIFF, PDF, JPEG, BMP, and ZIP).

Upload the supporting documentation using the upload utility. Participants will receive an email notification verifying that the claim

has been received or asking for more information.

4. EMAIL: Participants can submit a claim by attaching the claim form and receipt(s) to an email sent to paymeback@wageworksclaims.com. As stated above, attachments must be no larger than 5MB.

Most claims will be processed within one to two days after they are received and payments are sent shortly thereafter.

How to File a Claim

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My Benefits. My Life.

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Dependent Care Pay My Provider

Making

the most of your

reimbursement

account

It’s important to remember that, according to IRS regulations, if you spend less than your total account balance by the end of your reimbursement account program’s plan year you risk losing any money that’s left over.

So if you have money left in your dependent care accounts near the end of the year, make sure to spend it all and to submit any necessary claims and receipts for your expenses. You can also:

䡵Check for any receipts you may not have sent in.

䡵Schedule additional eligible services.

On the other hand, if you spend all the money in your reimbursement account well before the end of the year and still have expenses that could have been eligible, consider setting aside more next year.

If you can predict your future expenses fairly accurately, a higher contribution can save you even more in taxes.

You can pay many of your eligible dependent care expenses directly from your Dependent Care Reimbursement Account, with no need to fill out paper forms or send in receipts, using Dependent Care Pay My Provider, an optional way of getting reimbursement.

Why Use Pay My Provider

No claims to file.

Works like a bill pay service.

Deducts automatically from your Dependent Care Reimbursement Account.

Most convenient way to pay for eligible dependent care services on a monthly basis.

NOTE:WageWorks sends Pay My Provider checks out once a month on the date you request.

When to Use Pay My Provider

You have predictable dependent care expenses each month.

Your dependent care provider does not require payment in advance (before the first of the month) and will accept monthly payments.

How to Use Pay My Provider

1. Visit www.hr.duke.edu/reimbursement.

2. Click on “Login to Your Personal Account” and enter your Duke NetID and password.

3. Click on the “Dependent Care” tab. 4. Click “Request Pay My Provider.”

5. Confirm or enter your contact information. 6. Enter your provider information.

7. Enter dependent information. 8. Enter your payment amount.

9. WageWorks will make the requested payment from your account and mail it directly to your provider every month on the date you request.

Note: If you are not paid by your requested date and there is no available

balance when this payment is made, then no payment will be sent to the provider.

10. WageWorks will send you an email each time a requested payment is made.

Check your claims status online anytime by logging on to your personal account at www.hr.duke.edu/reimbursement(NetID and password required).

All claims (including resubmissions) must be received no later than April 15, 2012 (your Claim It By date as displayed on your Statement of Activity)* to be eligible for reimbursement.

* Statements of Activity are available online by logging on to your personal account at

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You must provide proof for each dependent care service listed on your Pay Me Back claim form. You must also always include your provider’s Tax Identification Number (TIN) or SSN. Your proof should be appropriate for the type of expense:

Recommended proof is to complete the Dependent Care claim form (available at www.hr.duke.edu/forms/reimbursement-dependent.php) and have the provider sign the form.

If no provider signature is provided on the claim form, attach a formal or informal statement or bill from the provider that indicates the dates of service, care provided and claim amount.

Dependent Care Reimbursement

Account Rules

The following rules are dictated by IRS regulations:

1. By enrolling in the plan, you authorize your employer to deduct your election amount from your paycheck on a pre-tax basis.

2. Your account can be used to pay for eligible services incurred while you are enrolled during the plan year. Expenses are considered incurred on the day of service, not when you

are billed or pay. 3. Your account cannot be

used to pay for expenses incurred before or after you are covered under this plan or for services you plan to receive in the future. If you must pay for a service in advance, you can file a claim for

reimbursement only after you begin to receive that service.

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4. You will need to provide the Social Security or Tax ID number of your dependent care provider to request payments or get reimbursed from your Dependent Care Reimbursement Account. You will also be required to report it to the IRS when you file your tax return form.

5. Your account can only be used to pay for work-related and eligible dependent care expenses for which you have not and will not seek reimbursement from any other plan or source.

6. You cannot take a deduction or a tax credit on your tax return form for any dependent care expense paid for through this account.

7. You are responsible for maintaining documentation (e.g. detailed receipts) to verify your expenses (the nature of each expense, the amount and the date incurred). Keep these with your other important tax papers for the calendar year.

8. You will have until April 15, 2012 (your Claim It By date) to get reimbursed from your account (by filing a Pay Me Back claim form) for eligible expenses incurred before December 31, 2011 (your Spend It By date). Both dates are displayed online and on your Statement of Activity and subject to change should you stop participating in this plan before the end of the plan year.

9. Be sure to incur eligible expenses totaling your election amount before December 31, 2011 (your Spend It By date). Any balance remaining in your account after April 15, 2012 (your Claim It By date) cannot be rolled over or paid out to you and will be forfeited.

10. If you want to participate during the next plan year, you will need to re-enroll during the open enrollment period. Duke is not allowed to keep you enrolled or automatically re-enroll you.

11. You may be able to enroll, change or cancel your enrollment during the plan year if you have experienced a qualified change as defined and if allowed by Duke’s plan.

12. Participation in this plan reduces your taxable income and may affect other compensation-based benefits such as life insurance, disability and Social Security. 13. Consult a tax advisor if you have any questions regarding your personal

situation.

14. If your salary is above $110,000, federal law may require your dependent care election to be readjusted based on the results of discrimination testing. If you are affected, you will be notified during the plan year of any necessary adjustment to your contribution amount.

My Benefits. My Life.

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You are encouraged to establish your online account at www.hr.duke.edu/ reimbursementand provide an email address in your profile so that WageWorks can communicate with you regarding time-sensitive information like claims notification and account updates.

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Adult day care center ...Yes After school program ...Yes Au pair ...Yes Babysitting (not work-related, for other purpose) ...No Babysitting (work-related, in your home or someone else’s) ...Yes Babysitting by your relative who is not a tax dependent (work-related) ....Yes Babysitting by your tax dependent (work-related or for other purpose) ....No Before- or after-school program ...Yes Child care ...Yes Custodial elder care (not work-related,for other purpose)...No Custodial elder care (work-related) ...Yes Dance lessons ...No Day nursing care ...No Dependent or elder care (while you work,

to enable you to work or look for work) ...Yes Educational services (for preschool) ...Yes Educational, learning or study skills services ...No Elder care (in your home or someone else’s) ...Yes Extended care

(supervised program before or after regular school hours) ...Yes Household services (housekeeper, maid, cook, etc.) ...No Housekeeper who cares for child

(only portion of payment attributable to work-related child care) ...Yes

Intersession camp ...Yes Kindergarten tuition ...No Language classes ...No Medical care ...No Nanny ...Yes Nursery school ...Yes Nursing home care ...No Payroll taxes related to eligible care ...Yes Piano lessons ...No Preschool ...Yes Private school tuition (for kindergarten and up) ...No School tuition ...No Senior day care ...Yes Sick child care ...Yes Sleep-away camp ...No Summer day camp ...Yes Transportation to and from eligible care

(provided by your care provider) ...Yes Transportation to and from eligible care

(provided by other than your care provider) ...No Tutoring ...No

* In order for the services to be covered, your dependent must meet the definitions as described on page 4 and above.

Product/Service Covered Product/Service Covered

What’s Covered by Your Dependent Care Reimbursement Account

All of the following must be true about the dependent care:

The care is for children up to their 13th birthday or for other individuals whom you claim as a dependent on your federal income tax return, regardless of age, who live with you and are incapable of caring for themselves.

The care is provided while you work or to enable you to work. If you are married, the care is provided while your spouse also works or to enable your spouse to work or go to school full-time (at least five months a year) or while your spouse is incapable of self-care.

The care may be provided by a relative or a non-relative, but it may not be provided by your child under the age of 19 (tax dependent or not) or another tax dependent.

Your care provider conforms to state and local laws (including being licensed, if required) and is able to provide you with his/her Social Security or Tax ID number. You will need this to request a payment or file a claim.

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What’s Covered by Your Dependent

Care Reimbursement Account

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My Benefits. My Life.

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Don’t forg

et to sign

and date the f

orm. A provider ’s signature, along with a Tax ID nu mber or Social Sec urity number, re place the need for re ceipt or other proo f of service.

References

Related documents

LIFE INSURANCE BENEFIT If your dependent dies while insured for these benefits, a benefit of $4,000 for your spouse or $2,000 for a dependent child is payable to you. If you

If you are enrolled in DCRA through December 31 of any plan year and have a remaining account balance, you can still fle claims for reimbursement under the grace period

You have the option to take either a tax credit on your federal income tax return for your dependent care expenses or receive pre-tax reimbursement of expenses through an.

If you terminate employment during the Plan Year, you will be able to request reimbursement from your MEDFLEX account for eligible medical and dental care expenses incurred up to

3 When you submit a claim for your eligible health care expenses and/or dependent care expenses, you will re- ceive reimbursement from your HCFSA Program and/or DeCAP

I request reimbursement for my dependent care expenses and/or dental, vision care as itemized above. Enclosed are receipts which state: date of service, provider name, type of

Dependent Care Flexible Spending Account : I elect $____________ per payroll or $_________ for the plan year to be contributed on a pre-tax basis to my Dependent Care

This section applies to the following accounts: Wells Fargo Business Choice Checking Wells Fargo Platinum Business Checking Wells Fargo Simple Business Checking Wells