Page 10 - VIP Mortgage Benefit Guide FINAL

Flexible Spending Account FSA

VIP Mortgage, Inc is offering a Flexible Spending Account (FSA) for 2021 – 2022 through EBC Flex. This is
how an FSA works:
› You set aside money for your FSA from your paycheck before taxes are taken out.
› Then use your pre-tax FSA funds throughout the plan year to pay for eligible health care or dependent
care expenses.
› You save money on expenses you’re already paying for.
› Use it or Lose It! Unused funds will be forfeited at the end of the plan year (May 2021 – April 2022)

2021 Annual FSA Contribution Limit
$2,750 Annual

LIMITED FSA
HEALTH FSA ELIGIBLE EXPENSES
ELIGIBLE EXPENSES

› Medical expenses: co-pays, co-insurance, and › Dental visit expenses: co-pays, co-insurance,
deductibles and services not covered at 100%
› Dental expenses: exams, cleanings, X-rays, and › Dental operations
braces › Braces
› Vision expenses: exams, contact lenses and › Vision visit expenses: co-pays, materials, and
supplies, eyeglasses, and laser eye surgery lasik services
› Professional services: physical therapy,
chiropractor, and acupuncture
› Prescription drugs and insulin
› Over-the-counter health care items: bandages,
pregnancy test kits, blood pressure monitors,
etc.

Refer to your FSA documentation for more information.

This booklet provides only a summary of your benefits. All services described within
2021 -2022 Employee Benefit Guide
are subject to the definitions, limitations, and exclusions set forth in each insurance 10
carrier or provider’s contract.