Page 10 - Great Circle 2022 Benefits Guide
P. 10
FSA
What is a Flexible Spending Account (FSA)?
With Medical Plan 1 or 2 you can choose to enroll in a lexible spending account (FSA) which allows you to
set aside pre-tax dollars from your paycheck to cover qualiied expenses you would normally pay out of your
pocket with after-tax dollars. We ofer two types of lexible spending account programs.
Healthcare FSA Dependent Care FSA
The healthcare FSA helps you pay for certain IRS- The dependent care FSA lets you set aside pre-tax
approved medical care expenses not covered dollars to use toward qualiied dependent care.
by your insurance plan with pre-tax dollars. The The maximum amount you may contribute to the
maximum contribution to the healthcare FSA is dependent care FSA is $5,000 (or $2,500 if married
$2,750 per plan year. and iling separately) per plan year. Funds you
contribute to the dependent care FSA function like a
Funds you elect to contribute to the healthcare FSA debit card; you need to accumulate the funds before
are available in full on the irst day of the plan year. you can use them.
For example, if you elect to contribute $1,000, the
full election is available to you on day one. You’ll This plan requires re-enrollment each year if you
continue to pay for the election pre-tax from your wish to participate.
paycheck throughout the plan year.
Use It or Lose It
This plan requires re-enrollment each year if you
wish to participate. If you are Medicare enrolled Carefully consider your FSA contribution amounts
and actively working you can still participate in the for the plan year. At the end of the year, you lose
Flexible Spending Account. any money left over in your FSA. In the healthcare
FSA, you may rollover up to $500 unused Healthcare
FSA dollars from one year to the next. Employees
must make an active healthcare FSA election each
year in order for the rollover to apply.
Eligible Expenses
Healthcare FSA Dependent Care FSA
z Doctor’s visit copays z Cost of child or adult daycare*
z Prescription drug copays z Nursery school
z Medical and dental deductibles z Preschool (excluding kindergarten)
z Over-the-counter medications (with a written * Eligible dependent: tax dependent child under age 13; tax
prescription) dependent spouse, parent, or child unable to care for themselves.
z Hearing aids
z Eyeglasses
10
What is a Flexible Spending Account (FSA)?
With Medical Plan 1 or 2 you can choose to enroll in a lexible spending account (FSA) which allows you to
set aside pre-tax dollars from your paycheck to cover qualiied expenses you would normally pay out of your
pocket with after-tax dollars. We ofer two types of lexible spending account programs.
Healthcare FSA Dependent Care FSA
The healthcare FSA helps you pay for certain IRS- The dependent care FSA lets you set aside pre-tax
approved medical care expenses not covered dollars to use toward qualiied dependent care.
by your insurance plan with pre-tax dollars. The The maximum amount you may contribute to the
maximum contribution to the healthcare FSA is dependent care FSA is $5,000 (or $2,500 if married
$2,750 per plan year. and iling separately) per plan year. Funds you
contribute to the dependent care FSA function like a
Funds you elect to contribute to the healthcare FSA debit card; you need to accumulate the funds before
are available in full on the irst day of the plan year. you can use them.
For example, if you elect to contribute $1,000, the
full election is available to you on day one. You’ll This plan requires re-enrollment each year if you
continue to pay for the election pre-tax from your wish to participate.
paycheck throughout the plan year.
Use It or Lose It
This plan requires re-enrollment each year if you
wish to participate. If you are Medicare enrolled Carefully consider your FSA contribution amounts
and actively working you can still participate in the for the plan year. At the end of the year, you lose
Flexible Spending Account. any money left over in your FSA. In the healthcare
FSA, you may rollover up to $500 unused Healthcare
FSA dollars from one year to the next. Employees
must make an active healthcare FSA election each
year in order for the rollover to apply.
Eligible Expenses
Healthcare FSA Dependent Care FSA
z Doctor’s visit copays z Cost of child or adult daycare*
z Prescription drug copays z Nursery school
z Medical and dental deductibles z Preschool (excluding kindergarten)
z Over-the-counter medications (with a written * Eligible dependent: tax dependent child under age 13; tax
prescription) dependent spouse, parent, or child unable to care for themselves.
z Hearing aids
z Eyeglasses
10
