Page 15 - 2022 Benefits Resource Guide

Section 125 plan & flexible spending accounts, cont.

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 Health Care FSA, you may roll over up to $550 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.

Using your FSA account & reimbursements
There are a few ways to spend your FSA contribution to pay for eligible
expenses as shown below. If you need to submit a manual claim, claim
forms are on myuhc.com.

■ Using your FSA Mastercard – If you enroll in the FSA, you will
receive an FSA MasterCard to pay for eligible expenses and
services. If you do not use your FSA MasterCard, you may be
reimbursed based on the type of expense (shown below).
■ Dependent care reimbursements – Submit a Dependent Care
Flexible Spending Account Claim Form.
■ Health care reimbursements – For an in-network medical
claim, UnitedHealthcare will automatically process a check
reimbursement from your FSA. You may also provide
UnitedHealthcare with banking information to have
reimbursements paid to you via direct deposit. 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 reimbursement – Submit a Health Care
FSA Claim Form.

12 Employee Benefits Guide