Page 8 - Guide
P. 8
Eligible Expenses FSA
Healthcare FSA What is a Flexible Spending Account (FSA)?
Doctor’s visit copays
A lexible spending account (FSA) allows you to set aside pre-tax dollars
Prescription drug copays from your paycheck to cover qualiied expenses you would normally pay
out of your pocket with after-tax dollars. We offer [one/two/three] types
Medical and dental deductibles
of lexible spending account programs.
Over-the-counter medications
(with a written prescription)
Healthcare FSA
Hearing aids
The healthcare FSA helps you pay for certain IRS-approved medical care
Eyeglasses expenses not covered by your insurance plan with pre-tax dollars. The
Limited Health FSA maximum contribution to the healthcare FSA is $2,600 per plan year.
Hearing aids Funds you elect to contribute to the healthcare FSA are available in full
Eyeglasses on the irst day of the plan year. For example, if you elect to contribute
$1,000, the full election is available to you on day one. You’ll continue to
Dental cleanings
pay for the election pre-tax from your paycheck throughout the plan year.
Eye exams
Dependent Care FSA Limited Health FSA
Cost of child or adult day care* The limited health FSA is similar to the healthcare FSA except you are
limited to spending your pre-tax dollars on eligible dental and vision care
Nursery school
services only.
Preschool (excluding
kindergarten) Dependent Care FSA
* Eligible dependent: tax dependent
child under age 13; tax dependent The dependent care FSA lets you set aside pre-tax dollars to use toward
spouse, parent, or child unable to
care for themselves qualiied dependent care. The maximum amount you may contribute
to the dependent care FSA is $5,000 (or $2,500 if married and iling
separately) per plan year. Funds you contribute to the dependent care FSA
function like a debit card; you need to accumulate the funds before you
can use them.
Use It or Lose It
Carefully consider your FSA contribution amounts for 2017. At the end
of the year or grace period, you lose any money left over in your FSA.
8 2018 Benefits Enrollment
Healthcare FSA What is a Flexible Spending Account (FSA)?
Doctor’s visit copays
A lexible spending account (FSA) allows you to set aside pre-tax dollars
Prescription drug copays from your paycheck to cover qualiied expenses you would normally pay
out of your pocket with after-tax dollars. We offer [one/two/three] types
Medical and dental deductibles
of lexible spending account programs.
Over-the-counter medications
(with a written prescription)
Healthcare FSA
Hearing aids
The healthcare FSA helps you pay for certain IRS-approved medical care
Eyeglasses expenses not covered by your insurance plan with pre-tax dollars. The
Limited Health FSA maximum contribution to the healthcare FSA is $2,600 per plan year.
Hearing aids Funds you elect to contribute to the healthcare FSA are available in full
Eyeglasses on the irst day of the plan year. For example, if you elect to contribute
$1,000, the full election is available to you on day one. You’ll continue to
Dental cleanings
pay for the election pre-tax from your paycheck throughout the plan year.
Eye exams
Dependent Care FSA Limited Health FSA
Cost of child or adult day care* The limited health FSA is similar to the healthcare FSA except you are
limited to spending your pre-tax dollars on eligible dental and vision care
Nursery school
services only.
Preschool (excluding
kindergarten) Dependent Care FSA
* Eligible dependent: tax dependent
child under age 13; tax dependent The dependent care FSA lets you set aside pre-tax dollars to use toward
spouse, parent, or child unable to
care for themselves qualiied dependent care. The maximum amount you may contribute
to the dependent care FSA is $5,000 (or $2,500 if married and iling
separately) per plan year. Funds you contribute to the dependent care FSA
function like a debit card; you need to accumulate the funds before you
can use them.
Use It or Lose It
Carefully consider your FSA contribution amounts for 2017. At the end
of the year or grace period, you lose any money left over in your FSA.
8 2018 Benefits Enrollment
