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You cannot change these elections during the plan year without a qualifying
change in status (refer to the Changing Your Elections section for
more information).

Health care flexible spending account
A health care FSA allows you to set aside money on a pre-tax basis and use
that money to pay for eligible medical, prescription, dental, vision, and certain
over-the counter medical supplies for you and/or your dependents. Qualifying
expenses are those permitted by Section 213 of the Internal Revenue Code.
The maximum contribution to a health care FSA is $2,750 per plan year, and
the minimum is $100 per plan year.
Dependent care flexible spending account
A dependent care FSA allows you to set aside money on a pre-tax basis and
use that money to pay for work-related dependent day care costs. If you are
married, you can only use the account if both you and your spouse work or, in
some situations, if your spouse goes to school full-time.

An eligible dependent is any member of your household for whom you can
claim expenses on Federal Income Tax Form 2441 (Credit for Child and
Dependent Care Assistance Expenses). Children must be under the age of 13,
and you must be the custodial parent. Dependents over age 13 must be
physically or mentally unable to care for themselves and must live with you
for at least eight hours a day.

The following arrangements qualify as eligible expenses under the dependent
care FSA:

■ A dependent (day) care center. The facility must comply with
applicable state and local laws if the facility provides care for more
than six individuals.
■ An educational institution for pre-school children. For older children,
only expenses for non-school care are eligible.
■ An individual who provides care inside or outside your home. The
individual may not be a child of yours under age 19 or anyone you
claim as a dependent for federal tax purposes.
Note: Fees for registration, private schools, kindergarten, overnight camps,
and extra activities are not eligible for reimbursement.

The minimum contribution to a dependent care FSA is $100 per plan year.
Federal law limits maximum contributions to dependent care spending
accounts. You may only contribute the lesser of: (a) $5,000 if 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.

10 Employee Benefits Guide