Page 16 - 2023 Employee Benefits Guide

you are married filing a joint return, or you are head of a household, or
$2,500 if you are married filing separate returns; (b) your taxable
compensation; (c) your spouse’s actual or deemed income (a spouse
who is a full-time student or incapable of caring for him/herself has a
monthly earned income of $200 for one dependent, or $400 for two or
more dependents).

If you elect not to participate in the dependent care FSA, you may be
eligible to receive a tax credit for certain dependent care expenses. If
you participate in the dependent care FSA, you are not eligible for the
tax credit in that tax year. Consult your tax advisor regarding which
option best meets your needs.

FSA rules & regulations
Below are IRS regulations regarding the Section 125 plan and Flexible
Spending Accounts:
› Each type of FSA account is separate, the monies cannot
be commingled.
› Expenses must be incurred during the plan year.
› For the 2023 Health Care FSA, you may roll over up to $610 from
one plan year to the next. Balances more than this allowed
rollover amount are forfeited at the end of the plan year.
› For the Dependent Care FSA, unused account balances at the end
of the plan year will be forfeited.
› You have 90 days after the end of the plan year to submit claims
for expenses occurred during the plan year.
› You must make new elections each plan year during annual open
enrollment to continue your participation.
FSA MasterCard & reimbursements

You will receive an FSA MasterCard to pay for all eligible expenses and
services, including health care, pharmacy, and dependent care. If you do
not use the FSA MasterCard, you will can reimbursed as shown below.
› Health care expense – If you do not use the FSA MasterCard,
UnitedHealthcare will automatically process a check
reimbursement from your FSA for in-network claims. You may
also provide UnitedHealthcare with banking information to have
reimbursements paid to you via direct deposit. You can turn off
this automatic processing by updating your profile in MyUHC.com.
For an out-of-network medical claim, submit a Health Care FSA
Claim Form. Services cannot be reimbursed by any other health
care plan or program, federal, state, or governmental program,
workers’ compensation, or any other insurance policy.
› Pharmacy purchase reimbursements – Use your FSA
MasterCard, or submit a Health Care FSA Claim Form to request
reimbursement.
› Dependent care expenses – Use your FSA MasterCard or
submit a Dependent Care Flexible Spending Account Claim Form
to request reimbursement.
If you need to submit a manual claim, claim forms are on myuhc.com.

12 Employee Benefits Guide