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Flexible Spending Accounts

A Flexible Spending Account (FSA) helps you pay for health care or dependent care costs using tax-free dollars. Your
contribution is deducted from your paycheck on a pretax basis and is put into the FSA. When you incur expenses, you can
access the funds in your account to pay for eligible expenses. This chart shows the eligible expenses for each FSA and
how much you can contribute each year. Each of these options reduces your taxable income.

Account type Eligible expenses Annual contribution limits
Most medical, dental and vision care expenses Maximum contribution is $2,850 per year.
Health Care FSA that are not covered by your health plan (such as Funds are deducted throughout the year,
copayments, coinsurance, deductibles, eyeglasses but all funds are available on January 1.
and prescriptions)
Dental and vision expenses only that are not covered Maximum contribution is $2,850 per year.
by your health plan (such as copayments, coinsurance, This is available to those enrolled in the
Limited Purpose FSA deductibles, eyeglasses and prescriptions) HDHP plan with an HSA.
Funds are deducted throughout the year,
but all funds are available on January 1.
Dependent care expenses (such as day care, Maximum contribution is $5,000 per year
after school programs or eldercare programs) ($2,500 if married and filing separate
Dependent Care FSA for children under age 13 or eldercare so you and tax returns).
your spouse can work or attend school full-time Funds are available for use as soon as your
contributions are deposited into your account
throughout the year.

Important information about FSAs
Your FSA elections are effective from January 1 through December 31. Claims for reimbursement must be
submitted by March 31 of the following year. Our Health Care and Limited Purpose FSAs allow you to carry over
$570 in unused funds to the following plan year.
Please plan your contributions carefully. Any unused money remaining in your account(s) will be forfeited.
This is known as the “use it or lose it” rule and it is governed by Internal Revenue Service regulations. Note that
FSA elections do not automatically continue from year to year; you must actively enroll each year.

Your unused 2021 FSA balance, if any, will be available in 2022. The recent COVID-relief bill
provides access to remaining 2021 FSA funds for 2022 (next year).
The recently passed Consolidated Appropriations Act 2021 (CAA) stimulus bill included COVID relief options for Flexible
Spending Account (FSA) members. Specifically, employers can allow their Health Care FSA members to carry over all unused
balances from their 2021 account, if any, to their 2022 account.

If you have money left in your 2021 PayFlex Health FSA, this notice is to confirm that all your unused 2021 FSA funds, if any,
will be carried over to your applicable 2022 account. (Prior to the CAA, you could only carry over $550 from 2021 to 2022.)

What are your next steps?
No action is required. You can continue using your FSA to pay for eligible expenses throughout the plan year. You are
being informed of this change in the event it may affect your choices during this year.
● Log in to payflex.com, your PayFlex member website to view your balance and account details.
You can also log in to the PayFlex Mobile® app.
●
If you have eligible out-out-pocket expenses, select file a claim to get reimbursed from your account.
●
● If you aren’t sure what’s considered an eligible expense, review the list on payflex.com. Or use the Eligible Expense
Scanner on the PayFlex app.
Questions?
Log in to your PayFlex member website. Help & Support to email or chat with us.
●
● Or call us at 844-729-3539 (TTY: 711). We’re here to help Monday–Friday, 7am–7pm CT, and Saturday, 9am–2pm CT.

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