Page 12 - 2017-18 Optimas Benefits Guide
P. 12
Flexible Spending Accounts
Eligible Expenses Limited Purpose FSA
Limited Purpose FSA The limited purpose FSA is available to you and your dependents
regardless of any other beneit coverage elections. The limited purpose
Dental cleanings FSA allows you to spend pre-tax dollars on eligible dental and vision care
Orthodontia services services only. The annual maximum contribution to the limited purpose
FSA is $2,600. Funds you elect to contribute to the limited purpose FSA
Eye exams
are available in full on the irst day of the plan year. You may submit
Eyeglasses eligible dental or vision expenses for reimbursement or you may pay for
Dependent Care FSA eligible expenses at the time of service using your FSA debit card. Refer
Cost of child or adult day care* to www.spendingaccounts.info for more information about FSAs.
Nursery school Dependent Care Flexible Spending Accounts
Preschool (excluding The dependent care FSA lets you set aside pre-tax dollars to use toward
kindergarten)
qualiied dependent care. The maximum amount you may contribute
* Eligible dependent: tax dependent to the dependent care FSA is $5,000 (or $2,500 if married and iling
child under age 13; tax dependent
spouse, parent, or child separately) per plan year. Once you pay your provider, you may submit
proof of your expense and a reimbursement check will be sent to you
once the funds have been withheld from your paycheck. It’s that easy!
FSA Contributions
If you contribute to one or both FSAs, keep in mind the IRS monitors
While many payments made with FSA contributions on a calendar year basis, thus any contributions
your FSA debit card are approved you’ve made from January to June are a part of your total calendar year
automatically, the FSA administrator contribution. Please consult with Human Resources for more guidance
may request for substantiation regarding your FSA program contributions.
to verify the expense. Failure to
respond to substantiation requests
will result in suspension of your Use It or Lose It
debit card. You lose any money left over in your FSA, so make sure you carefully
decide how much to set aside in your accounts. Incurred expenses during
the July 2017 through June 2018 plan year must be submitted no later
than September 30, 2018 for reimbursement.
12 2017–18 Benefits Enrollment
Eligible Expenses Limited Purpose FSA
Limited Purpose FSA The limited purpose FSA is available to you and your dependents
regardless of any other beneit coverage elections. The limited purpose
Dental cleanings FSA allows you to spend pre-tax dollars on eligible dental and vision care
Orthodontia services services only. The annual maximum contribution to the limited purpose
FSA is $2,600. Funds you elect to contribute to the limited purpose FSA
Eye exams
are available in full on the irst day of the plan year. You may submit
Eyeglasses eligible dental or vision expenses for reimbursement or you may pay for
Dependent Care FSA eligible expenses at the time of service using your FSA debit card. Refer
Cost of child or adult day care* to www.spendingaccounts.info for more information about FSAs.
Nursery school Dependent Care Flexible Spending Accounts
Preschool (excluding The dependent care FSA lets you set aside pre-tax dollars to use toward
kindergarten)
qualiied dependent care. The maximum amount you may contribute
* Eligible dependent: tax dependent to the dependent care FSA is $5,000 (or $2,500 if married and iling
child under age 13; tax dependent
spouse, parent, or child separately) per plan year. Once you pay your provider, you may submit
proof of your expense and a reimbursement check will be sent to you
once the funds have been withheld from your paycheck. It’s that easy!
FSA Contributions
If you contribute to one or both FSAs, keep in mind the IRS monitors
While many payments made with FSA contributions on a calendar year basis, thus any contributions
your FSA debit card are approved you’ve made from January to June are a part of your total calendar year
automatically, the FSA administrator contribution. Please consult with Human Resources for more guidance
may request for substantiation regarding your FSA program contributions.
to verify the expense. Failure to
respond to substantiation requests
will result in suspension of your Use It or Lose It
debit card. You lose any money left over in your FSA, so make sure you carefully
decide how much to set aside in your accounts. Incurred expenses during
the July 2017 through June 2018 plan year must be submitted no later
than September 30, 2018 for reimbursement.
12 2017–18 Benefits Enrollment
