03-08-2006 Council Agenda - Laserfiche WebLink

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Flexible Benefit Plan Renewal City of Little Canada (company name) Passport Benefit Solutions welcomes the opportunity to continue providing Flexible Spending Account services for your company. We strive to provide excellent service to you and your employees. Passport will continue to look for ways to provide top of the line service to you through technology and administration. We value your business and look forward to our continued partnership, so we are pleased to offer you the same rate for 2006 administration and no cost to renew your plan. We would like to get a jump start on renewing your services; please answer the questions below and complete the attached excel spreadsheet to ensure that we renew your plan with ease this year. Please return this form and excel sheet to us by February 10, 2006 so we can ensure a smooth enrollment for your 2006 plan. ❑ No, we do not wish to renew our flex plan Yes, we would like to renew our flex plan with Passport Benefit Solutions for the 2006 plan year. Notes: ❑ Yes No The plan limits should remain the same as 2005's plan Yes No Collect receipts prior to reimbursement of claims (recommended)* Yes ❑ No Add the 2 1 month grace period for filing claims to the 2006 plan ** Yes No Open enrollment period3- /3 -06-• 3 -2V-05" (must end by 11/30/05) Yes No Run discrimination testing on my 2005 plan Yes No We would like to add COBRA, HSA, HRA or Transportation plan services, please contact me ❑ Yes No We have additional changes to make to the plan, please contact me Two Employee Classes - Regular Employee and Elected Employee Plan Limit - $3,000 /Annually Plan to Convert to Calendar Year Basis, i.e. 4/1/06 through 12/31/06 and annually thereafter r� • Steps: 1. Email or Fax this sheet to slanuszewski @passportbenefit.com or 952-852-7089 fax 2. Email the attached excel spreadsheet with current employee information. • If you wish to have discrimination testing performed on your 2005 flex plan, please provide 2004 gross income for each employee in the appropriate column on the attached spreadsheet. 3. After we have received the above, we will email plan documents and enrollment information to you. Upon completion of open enrollment, you will receive an Enrollment Report, detailing employee elections and payroll deductions. If you would like to schedule an employee meeting, please indicate this in the notes section above. * Requiring receipts before claims are paid decreases the number of denied claims and money due to be re- collected by your company. We strongly encourage you to adopt this practice for the 2006 plan year, if you have not already. ** The grace period allows employees to file claims that incurred up to 2'h months after the plan year ends. For example, employees can file claims for the 2006 plan year through March 15, 2007. This is not recommended if you plan to offer a Health Savings Account plan at your next medical insurance renewal. We look forward to continue working with you in 2006! Stephanie Januszewski, Passport Benefit Solutions, LLC 952 - 852 -7024 sjanuszewski @ passportbenefit.com i t;. . �! L' - emplover@passporthenefit.com main 0 352:1091 iat