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~~ <br /> You may use your HCSP account to cover ACCOUNT NAME P~RisklRe xrd ~ ANNUAL FEE' <br /> the cost of health and dental insurance (paid <br /> aftertaxes),1ong term-care insurance, and Money Market .01% <br /> monthly Medicare B premiums, In the table <br /> below; we list the mosfcommon reimbursable Fixed Interest ~ .09% <br /> expenses. For a completelist of reimbursable . <br /> expenses, see IRS publicafion 502. Note: The Bond Market .09% <br /> current IRS publication 502 supercedes all , <br /> MSRS documentation regarding reimbursable <br />O health care related expenses. 'Income Share .01% <br /> <br />/ <br />/ Q Acupuncture and acupressure Common Stock Index .02% <br />rl Alcoholism or drug dependency treatment <br />I and treatment centers Growth Share .23% <br />' Allergy medicine <br /> • Ambulance <br />International .30% <br /> • Analgesics <br />j Antacids 'Fees are subject to change. Pmentiauy Higher <br />RisWReward <br /> • Antibiotics, first aid <br /> • Anti-diarrhea medicine <br />Will I receive statements? <br /> • Antihistamines <br /> • Anti-inflammatory Yes. You will receive an account statement <br /> • Artificial limbs and teeth every six months. It will be mailed directly to <br /> • Aspirin your residence. <br /> Q Bandaids/bandages <br />1 Birth control devices (with prescription) <br />What is the cost? <br /> • Birth control pills <br /> • Braille books and magazines We deduct the HCSP administrative fee from <br />`, (to the extent prices exceed prices your account. The annual fee is 0.65 percent. This <br />`\ for regular books and magazines) fee is prorated and deducted monthly from your <br /> • Burn treatments account balance. For example, if you have an <br /> Q Car (with special medical equipment) account value of $10,000, we would deduct $5.42 <br /> • Childbirth preparation classes for mother, per month from your account. The maximum <br /> excluding portion for mother's coach ~ annual fee is $140 or $11.67 per month. All fees <br /> • Cold and flu medicine are subject to change. <br /> • Cold/hot packs <br /> • Contact lenses ' <br /> • Contact lens solutions/cleaners <br /> • Contraceptives <br /> • Corn/callus removers <br /> • Cough drops <br /> • Crutches <br /> <br />s HCSP 1-800-657-5757 ~ 7~1~296-2761 www.msrs.state.mn.us • fax 651-297-5238 6 <br /> <br />