Page 10 - NH NC Guide
P. 10
Dependent Care FSA
The Dependent Care FSA lets you use pre-tax dollars towards qualiied dependent
care. The maximum amount you may contribute to the Dependent Care FSA is
$5,000 (or $2,500 if married and iling separately) for the December 1, 2015 through
November 30, 2016 plan year.
Planning for any dependent child care expenses will not be affected at all by the
HRA.
Debit Card
Dependent Care Spending
Account The Health Equity FSA debit card is an easy way to keep cash in your
Cost of child or adult day care * pocket while using your FSA. Many payments made with the card are
approved automatically, so no further paperwork is required. Both
Nursery school
healthcare and dependent care expenses may be paid with the debit card.
Preschool (excluding kindergarten)
* Eligible Dependent If HealthEquity cannot determine the use of your debit card is for an
Tax dependent child under age 13 eligible expense, a request for substantiation will be sent which will require
Tax dependent spouse, parent, or child
unable to care for themselves you to submit a copy of the receipt which clearly indicates the nature of
the expense. The reason for this request is to prove funds were used to
pay eligible medical, dental, and vision care expenses. Failure to respond to
substantiation requests will result in the suspension of your debit card.
Your FSA debit card eligible expenses include medical out-of-pocket expenses not
covered by the HRA, dental, vision, pharmacy copays, and over-the-counter materials
and medication with a written prescription from your doctor.
The FSA debit card can be used to pay your portion of the deductible before the
HRA pays. The HRA will automatically begin to pay your portion of the deductible
once you have exceeded the $500 per individual or $1,000 per family deductible.
We suggest you wait to pay your portion of the deductible until you receive your
Explanation of Beneits (EOB) from BCBS of NC and you may use your FSA debit
card to pay your share of the deductible.
10
New Hire Guide
The Dependent Care FSA lets you use pre-tax dollars towards qualiied dependent
care. The maximum amount you may contribute to the Dependent Care FSA is
$5,000 (or $2,500 if married and iling separately) for the December 1, 2015 through
November 30, 2016 plan year.
Planning for any dependent child care expenses will not be affected at all by the
HRA.
Debit Card
Dependent Care Spending
Account The Health Equity FSA debit card is an easy way to keep cash in your
Cost of child or adult day care * pocket while using your FSA. Many payments made with the card are
approved automatically, so no further paperwork is required. Both
Nursery school
healthcare and dependent care expenses may be paid with the debit card.
Preschool (excluding kindergarten)
* Eligible Dependent If HealthEquity cannot determine the use of your debit card is for an
Tax dependent child under age 13 eligible expense, a request for substantiation will be sent which will require
Tax dependent spouse, parent, or child
unable to care for themselves you to submit a copy of the receipt which clearly indicates the nature of
the expense. The reason for this request is to prove funds were used to
pay eligible medical, dental, and vision care expenses. Failure to respond to
substantiation requests will result in the suspension of your debit card.
Your FSA debit card eligible expenses include medical out-of-pocket expenses not
covered by the HRA, dental, vision, pharmacy copays, and over-the-counter materials
and medication with a written prescription from your doctor.
The FSA debit card can be used to pay your portion of the deductible before the
HRA pays. The HRA will automatically begin to pay your portion of the deductible
once you have exceeded the $500 per individual or $1,000 per family deductible.
We suggest you wait to pay your portion of the deductible until you receive your
Explanation of Beneits (EOB) from BCBS of NC and you may use your FSA debit
card to pay your share of the deductible.
10
New Hire Guide
