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P. 12
2016 Benefits Enrollment
Flexible Spending Accounts
Healthcare Flexible Dependent Care Flexible Spending Accounts
Spending Accounts (FSA) The dependent daycare FSA permits you to pay for qualiied child
The healthcare FSA allows you and adult daycare expenses on a pre-tax basis. You’ll set aside an
to pay for eligible out-of-pocket amount of money through ixed payroll deductions to help pay for
healthcare expenses with pre-tax eligible dependent care expenses.
dollars. Eligible expenses include plan
deductibles, copays, coinsurance, and Qualiied expenses include, but are not limited to, licensed child and
other non-covered medical, dental, adult day care as well as summer camps paid to providers with a tax
and vision healthcare expenses for identiication number. Once you pay your provider, you may submit
you and your dependents. You may proof of your expense and a reimbursement check will be sent to you
access your entire plan year election once the funds have been withheld from your paycheck. It’s that easy!
from the irst day of the plan year.
You may submit eligible healthcare How Much Can I Contribute to My FSA?
expenses for reimbursement or The IRS limits the amount of money you can contribute to an FSA
may use your spending account program each year. You can elect to contribute up to the full IRS
debit card which allows you to pay mandated limits of $2,550 to your healthcare FSA or $5,000 to your
for eligible healthcare expenses dependent care FSA.
at the time of service. Refer to
www.spendingaccounts.info for If you contribute to one or both of these programs, keep in mind
eligible expenses and additional details the IRS monitors FSA contributions on a calendar year basis,
concerning the value of FSAs. You thus any contributions you’ve made from January to June are a
can participate in a healthcare FSA if part of your total calendar year contribution. Please consult with
you enroll in the Traditional Choice Human Resources for more guidance regarding your FSA program
Plus PPO. You cannot participate in contributions.
a healthcare FSA if you enroll in the
Consumer Choice Plus PPO. What Happens If I Don’t Use All Of The Funds In My
Account?
Your healthcare and dependent care FSA contributions are subject
to a “Use-It-or-Lose-It” rule, so make sure you carefully decide how
While many payments made with
your FSA debit card are approved much to set aside in your accounts. Incurred expenses during the July
automatically, the FSA administrator 2016 through June 2017 plan year must be submitted no later than
may request for substantiation to September 30, 2017 for reimbursement.
verify the expense. Failure to respond
to substantiation requests will result in
suspension of your debit card.
12
Flexible Spending Accounts
Healthcare Flexible Dependent Care Flexible Spending Accounts
Spending Accounts (FSA) The dependent daycare FSA permits you to pay for qualiied child
The healthcare FSA allows you and adult daycare expenses on a pre-tax basis. You’ll set aside an
to pay for eligible out-of-pocket amount of money through ixed payroll deductions to help pay for
healthcare expenses with pre-tax eligible dependent care expenses.
dollars. Eligible expenses include plan
deductibles, copays, coinsurance, and Qualiied expenses include, but are not limited to, licensed child and
other non-covered medical, dental, adult day care as well as summer camps paid to providers with a tax
and vision healthcare expenses for identiication number. Once you pay your provider, you may submit
you and your dependents. You may proof of your expense and a reimbursement check will be sent to you
access your entire plan year election once the funds have been withheld from your paycheck. It’s that easy!
from the irst day of the plan year.
You may submit eligible healthcare How Much Can I Contribute to My FSA?
expenses for reimbursement or The IRS limits the amount of money you can contribute to an FSA
may use your spending account program each year. You can elect to contribute up to the full IRS
debit card which allows you to pay mandated limits of $2,550 to your healthcare FSA or $5,000 to your
for eligible healthcare expenses dependent care FSA.
at the time of service. Refer to
www.spendingaccounts.info for If you contribute to one or both of these programs, keep in mind
eligible expenses and additional details the IRS monitors FSA contributions on a calendar year basis,
concerning the value of FSAs. You thus any contributions you’ve made from January to June are a
can participate in a healthcare FSA if part of your total calendar year contribution. Please consult with
you enroll in the Traditional Choice Human Resources for more guidance regarding your FSA program
Plus PPO. You cannot participate in contributions.
a healthcare FSA if you enroll in the
Consumer Choice Plus PPO. What Happens If I Don’t Use All Of The Funds In My
Account?
Your healthcare and dependent care FSA contributions are subject
to a “Use-It-or-Lose-It” rule, so make sure you carefully decide how
While many payments made with
your FSA debit card are approved much to set aside in your accounts. Incurred expenses during the July
automatically, the FSA administrator 2016 through June 2017 plan year must be submitted no later than
may request for substantiation to September 30, 2017 for reimbursement.
verify the expense. Failure to respond
to substantiation requests will result in
suspension of your debit card.
12
