Page 10 - C.J. Segerstrom 2022 Benefit Guide

FLEXIBLE SPENDING

ACCOUNTS

A Flexible Spending Account (FSA) is a program that helps you pay for health care and dependent care
costs using tax free dollars.

FSAs help you make your money go further by letting you set aside pretax dollars to pay for out-of-pocket health care costs
(including dental and vision) and dependent care costs. You may contribute:
• Health Care FSA: Up to $2,750 per calendar year
• Dependent Care FSA: Up to $5,000 per calendar year ($2,500 if married and filing separate tax returns)
• Limited-Purpose FSA: Up to $2,750 per calendar year
You can’t have an HSA and a Health Care FSA at the same time. Tax laws don’t allow you to participate in a Health Care FSA and an
HSA at the same time. However, if you are enrolled in the Aetna HSA, you can open and contribute to the Limited-Purpose FSA.
It can ONLY be used to reimburse eligible preventive care, dental, and vision expenses, since qualified medical expenses can be
reimbursed through your HSA. For a list of eligible expenses, see IRS publication 502 available at www.irs.gov, or call Employee
Benefits Corporation at 800-346-2126.

What can I use it for?

Annual
Important information Account Type and Eligible Expenses Contribution Limits Benefit
about FSAs
Your FSA elections are effective Health Care FSA Saves on eligible
from January 1 through Most medical, dental and vision care Maximum expenses not
December 31. You have until expenses that are not covered by your contribution is covered by
health plan (such as copayments, insurance;
March 15 of each year to incur $2,750 per year
coinsurance, deductibles, eyeglasses reduces your
expenses for reimbursement
and prescriptions) taxable income
from your previous year Health
Care FSA. You can submit
Dependent Care FSA Maximum
claims for reimbursement up
Dependent care expenses contribution is
until March 31 for the previous
(such as day care, after school $5,000 per year Reduces your
year’s expenses. Please plan programs or elder care programs) ($2,500 if married taxable income
your contributions carefully. so you and your spouse can work or and filing separate
This is known as the “use it or attend school full- time tax returns)
lose it” rule and it is governed
by Internal Revenue Service Limited Purpose FSA
regulations. Note that FSA Dental and vision care expenses Maximum Reduces your
elections do not automatically (such as eyeglasses, contact lenses, contribution is taxable income
continue from year to year; you lens solution, dental checkups, fillings, $2,750 per year
must actively enroll each year. and orthodontia)
*This is an example only; not your actual experience. It assumes a 25% federal income tax rate
marginal rate and a 7.7% FICA marginal rate. State and local taxes vary and are not included in
this example. However, you will save on any state and local taxes as well.

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