Page 14 - Yaskawa 2022 Open Enrollment Guide
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Flexible Spending Accounts
Yaskawa America, Inc. ofers three Flexible Spending Account (FSA) Programs through UnitedHealthcare.
Flexible Spending Accounts let you set aside a certain amount of your paycheck into an account on a pre-tax
basis. During the year you have access to these accounts for reimbursement of expenses you regularly pay,
such as healthcare and dependent day care. With the Healthcare FSA, you will have the lexibility of using a
prepaid beneits card at your provider’s oice or pharmacy.
Healthcare Flexible Spending
Examples of Healthcare Account
Reimbursement Account Eligible
Expenses: Can be established to help you pay for
Birth control pills Lasik eye surgery unreimbursed medical, dental, and vision expenses
Chiropractors Prescription medicines for you and your dependents with pre-tax dollars.
Coinsurance amounts Physical exams Those enrolled in the CDHP are not eligible to enroll
Deductibles Psychiatric care in this plan.
Dental Treatment X-Rays
Eye exams/eyeglasses
Flexible Spending Account money may be used to purchase Limited Healthcare Flexible
over-the-counter drugs and medicines such as ibuprofen, Spending Account for CDHP/
acetaminophen, or cough syrup only with a prescription from HSA Participants
your doctor. A copy of the prescription for over-the counter
medications is required once a year for claims payment.
Allows for out-of-pocket dental and vision expenses
You may use your Flexible Spending Account to purchase to be paid for on a pre-tax basis. These expenses
over-the-counter items that are not considered a drug or have been limited so that enrollment is compatible
a medicine such as bandages, carpal tunnel wrist supports, with eligibility rules related to Health Savings
blood pressure monitors, contact lens solution, etc.
Accounts. Limited Purpose FSA funds can be used
For a complete list of eligible expenses, visit: for eligible dental and vision expenses only.
www.irs.gov
IRS Publication 502: Medical and Dental Expenses
IRS Publication 503: Dependent Care Expenses Dependent Care Flexible
Spending Account
Funds can be used for your dependent(s) under the
2022 Calendar Year age of 13. Your dependent over age 13, or spouse
Maximum Contributions who is physically not able to care for himself or
herself is considered to be a qualiied dependent if
their expenses for care could qualify for the federal
Healthcare FSA $2,750
Limited FSA $2,750 income tax credit on your tax return.
Dependent Care FSA $5,000
Commuter FSA $270 (per month) Commuter Reimbursement
Account
Through Wageworks, Associates living in major
metropolitan areas may have the ability to set aside
pre-tax dollars to pay for commuting and parking
expenses. See Human Resources for more details.
14
Yaskawa America, Inc. ofers three Flexible Spending Account (FSA) Programs through UnitedHealthcare.
Flexible Spending Accounts let you set aside a certain amount of your paycheck into an account on a pre-tax
basis. During the year you have access to these accounts for reimbursement of expenses you regularly pay,
such as healthcare and dependent day care. With the Healthcare FSA, you will have the lexibility of using a
prepaid beneits card at your provider’s oice or pharmacy.
Healthcare Flexible Spending
Examples of Healthcare Account
Reimbursement Account Eligible
Expenses: Can be established to help you pay for
Birth control pills Lasik eye surgery unreimbursed medical, dental, and vision expenses
Chiropractors Prescription medicines for you and your dependents with pre-tax dollars.
Coinsurance amounts Physical exams Those enrolled in the CDHP are not eligible to enroll
Deductibles Psychiatric care in this plan.
Dental Treatment X-Rays
Eye exams/eyeglasses
Flexible Spending Account money may be used to purchase Limited Healthcare Flexible
over-the-counter drugs and medicines such as ibuprofen, Spending Account for CDHP/
acetaminophen, or cough syrup only with a prescription from HSA Participants
your doctor. A copy of the prescription for over-the counter
medications is required once a year for claims payment.
Allows for out-of-pocket dental and vision expenses
You may use your Flexible Spending Account to purchase to be paid for on a pre-tax basis. These expenses
over-the-counter items that are not considered a drug or have been limited so that enrollment is compatible
a medicine such as bandages, carpal tunnel wrist supports, with eligibility rules related to Health Savings
blood pressure monitors, contact lens solution, etc.
Accounts. Limited Purpose FSA funds can be used
For a complete list of eligible expenses, visit: for eligible dental and vision expenses only.
www.irs.gov
IRS Publication 502: Medical and Dental Expenses
IRS Publication 503: Dependent Care Expenses Dependent Care Flexible
Spending Account
Funds can be used for your dependent(s) under the
2022 Calendar Year age of 13. Your dependent over age 13, or spouse
Maximum Contributions who is physically not able to care for himself or
herself is considered to be a qualiied dependent if
their expenses for care could qualify for the federal
Healthcare FSA $2,750
Limited FSA $2,750 income tax credit on your tax return.
Dependent Care FSA $5,000
Commuter FSA $270 (per month) Commuter Reimbursement
Account
Through Wageworks, Associates living in major
metropolitan areas may have the ability to set aside
pre-tax dollars to pay for commuting and parking
expenses. See Human Resources for more details.
14
