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DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT

The Dependent Care FSA lets you set aside pretax dollars to help pay for daycare services for your eligible
dependents. The maximum amount you can contribute is $5,000 per year combined per joint filing, or
$2,500 if married and filing separate tax returns.

It’s important to estimate your expenses conservatively – the law requires that you use your expenses during
the plan year (the “use it or lose it” rule). See other Important Features below, for significant additional
clarification on the “use it or lose it” rule.

ANNUAL
ACCOUNT TYPE ELIGIBLE EXPENSES BENEFITS
CONTRIBUTION LIMITS
Most medical, dental and vision
care expenses not covered by your Maximum contribution per
health plan (such as copayments, individual is $2,750 per year Saves on eligible expenses not
Health Care FSA covered by insurance; reduces
coinsurance, deductibles, ($5,500 annual maximum
eyeglasses and doctor-prescribed per married couple) your taxable income
over-the-counter medications)
Maximum contribution per
Limited Purpose You can submit claims for eligible individual is $2,750 per year Reduces your taxable income
Health Care FSA vision and dental expenses ($5,500 annual maximum
per married couple)
Dependent care expenses
(such as daycare, after-school Maximum contribution
programs or elder care programs) is $5,000 per year
Dependent Care FSA so you and your spouse can work ($2,500 if married and filing Reduces your taxable income
or attend school full-time separate tax returns)

OTHER IMPORTANT FEATURES
• Both of these pretax accounts are subject to the “use it or lose it” rules.
• For the Dependent Care FSA, you will have a 2½ month grace period at the end of the plan year to file
claims that were incurred during the plan year.

FSAs HELP YOU SAVE ON YOUR TAXES

ACCOUNT TYPE WITH FSA WITHOUT FSA
Your taxable income $50,000 $50,000
Pretax contribution to Health Care and $2,000 $0
Dependent Care FSA
Federal and Social Security Taxes $11,701 $12,355
After-tax dollars spent on eligible expenses $0 $2,000
Spendable income after expenses and taxes $36,299 $35,645

Tax savings with the Health Care
and Dependent Care FSA $654 N/A

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FLEXIBLE SPENDING ACCOUNTS (FSA)