Flexible Spending Account (FSA)

FLEXIBLE SPENDING ACCOUNTS GUIDE

The Health Care and Dependent Day Care Flexible Spending Accounts allow you to put money aside on a pre-tax basis to pay for a wide range of eligible expenses.

• The Health Care Flexible Spending Account is for health care expenses for you and your dependents. 
• Dependent Care Flexible Spending Accounts are for Day Care Expenses for children under age 13 (see below).

You can enroll in these accounts during the annual open enrollment period; within 31 days of a qualified life event; or, as a new hire. Your annual election cannot be changed during the plan year unless you have a qualified change in family status.

Your pre-tax flexible spending contributions are used to reimburse you for eligible expenses incurred on or after your effective date of enrollment through the end of your plan year (or your termination date). The expenses reimbursed through these accounts cannot also be paid through another source or claimed on your tax return. Any contributions that remain in the account after the end of the plan year or termination date are forfeited.

HEALTH CARE FLEXIBLE SPENDING ACCOUNT

• Maximum contribution per year is $3,400.
• Mostly a “Use it or lose it” plan. You can roll over up to $680 into next plan year. Any funds above this would be forfeited.
• You don’t have to be enrolled in the company medical plan to elect a health care flexible spending account. (Employees enrolled in an HSA medical plan cannot enroll in Heath Care FSA.)
• Contributions to this account are used to reimburse your and/or your dependent’s eligible Health Care (medical, dental, and vision) expenses.
• Elections must be made each year (elections will not rollover at open enrollment).
• For a complete list of eligible Healthcare FSA expenses, visit www.irs.gov/forms-pubs/about-publication-502.

DEPENDENT DAY CARE FLEXIBLE SPENDING ACCOUNT

• Maximum contribution per year is $7,500 ($3,750 if you are married and filing separate income tax returns). Under federal tax law, there are certain rules that may cause the maximum contribution amount for a year to be lower than $7,500. See the Dependent Day Care Summary Plan Description for more information.
• “Use it or Lose it” – you must use all the funds you elect in the calendar year, or you will forfeit them.
• Contributions to this account are used to reimburse your eligible Dependent Day Care Expenses. Eligible dependents include a child under age 13, a disabled spouse or any adult you can claim as a dependent on your tax return that is physically or mentally unable to care for him/herself.
• Elections must be made each year (elections will not rollover at open enrollment.)
• For a complete list of eligible Dependent Care FSA expenses, visit www.irs.gov/forms-pubs/about-publication-503.