Page 24 - Franklin Madison 2021 Benefits Guide
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Flexible Spending Accounts
The Flexible Spending Account (FSA) Program allows you to save on important health and
dependent care expenses for you and your family members using pre-tax dollars. You do
not need to be enrolled in the medical plans to participate.
Use it or Lose it!
If you want to contribute to one or both of the FSAs for 2021, you must make an active election during annual enrollment. Your
FSA elections will not automatically carry over each year. The IRS requires that your 2021 funds be forfeited if not claimed for
eligible expenses incurred in 2021 by March 31, 2022.
Exception: If you are participating in the Healthcare Flexible Spending Account (FSA) in 2021, and you have a balance in your
FSA of $550 or less at the end of the year, that money will automatically carry over to 2022. If your Healthcare FSA balance as
of March 31, 2021 is $551 or more, $550 will carry over for your use in 2022.
The Healthcare FSA and Dependent Day Care FSA are separate accounts with diferent rules. You may not comingle or transfer
funds from one FSA to the other
There are two types of accounts: y Vision care, eyeglasses, contact lenses, solutions
y Healthcare FSA y Eye surgery, including laser vision correction
y Dependent Day Care FSA y Counseling and therapy
y Psychology and psychiatry
When you sign up for one or both of these FSAs,
pre-tax contributions will be deducted from your y Chiropractic care and acupuncture
paycheck throughout the year. Ineligible Expenses
Healthcare FSA You may not use your Healthcare FSA to pay for:
The Healthcare FSA lets you pay for out-of-pocket y Insurance and COBRA premiums, or a divorced
healthcare expenses with pre-tax dollars. You can spouse’s medical bills or COBRA premiums
contribute from $100 to $2,750 each year to this y Expenses reimbursed by other insurance plans
account. (including your spouse’s plans)
y Exercise equipment, hot tubs, whirlpool baths,
Eligible Expenses and swimming pools
You can use your Healthcare FSA to pay for medical y Over-the-counter medications without a
related expenses such as: prescription
y Prescriptions—for almost any medical condition y Cosmetic surgery
y Over-the-counter healthcare products like y Vitamins and natural foods
aspirin, allergy medication, antacid, and
antibiotics when prescribed by your doctor For a complete list of eligible expenses for Healthcare
y Copayments, coinsurance, deductibles FSA and Dependent Care FSA, refer to IRS Publication
502—“Medical and Dental Expenses” and IRS Publication
y Dental care, both preventative and restorative 503—“Child and Dependent Care Expenses” available
online through the IRS website www.irs.gov
y Orthodontia, child and adult
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The Flexible Spending Account (FSA) Program allows you to save on important health and
dependent care expenses for you and your family members using pre-tax dollars. You do
not need to be enrolled in the medical plans to participate.
Use it or Lose it!
If you want to contribute to one or both of the FSAs for 2021, you must make an active election during annual enrollment. Your
FSA elections will not automatically carry over each year. The IRS requires that your 2021 funds be forfeited if not claimed for
eligible expenses incurred in 2021 by March 31, 2022.
Exception: If you are participating in the Healthcare Flexible Spending Account (FSA) in 2021, and you have a balance in your
FSA of $550 or less at the end of the year, that money will automatically carry over to 2022. If your Healthcare FSA balance as
of March 31, 2021 is $551 or more, $550 will carry over for your use in 2022.
The Healthcare FSA and Dependent Day Care FSA are separate accounts with diferent rules. You may not comingle or transfer
funds from one FSA to the other
There are two types of accounts: y Vision care, eyeglasses, contact lenses, solutions
y Healthcare FSA y Eye surgery, including laser vision correction
y Dependent Day Care FSA y Counseling and therapy
y Psychology and psychiatry
When you sign up for one or both of these FSAs,
pre-tax contributions will be deducted from your y Chiropractic care and acupuncture
paycheck throughout the year. Ineligible Expenses
Healthcare FSA You may not use your Healthcare FSA to pay for:
The Healthcare FSA lets you pay for out-of-pocket y Insurance and COBRA premiums, or a divorced
healthcare expenses with pre-tax dollars. You can spouse’s medical bills or COBRA premiums
contribute from $100 to $2,750 each year to this y Expenses reimbursed by other insurance plans
account. (including your spouse’s plans)
y Exercise equipment, hot tubs, whirlpool baths,
Eligible Expenses and swimming pools
You can use your Healthcare FSA to pay for medical y Over-the-counter medications without a
related expenses such as: prescription
y Prescriptions—for almost any medical condition y Cosmetic surgery
y Over-the-counter healthcare products like y Vitamins and natural foods
aspirin, allergy medication, antacid, and
antibiotics when prescribed by your doctor For a complete list of eligible expenses for Healthcare
y Copayments, coinsurance, deductibles FSA and Dependent Care FSA, refer to IRS Publication
502—“Medical and Dental Expenses” and IRS Publication
y Dental care, both preventative and restorative 503—“Child and Dependent Care Expenses” available
online through the IRS website www.irs.gov
y Orthodontia, child and adult
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