Page 15 - 2018 VER Benefit Guide
P. 15
How Much to Contribute
How Much Do You Spend Out-of-Pocket During an Average Year
on… Amount
Routine Doctor Visits?
Hospital Services?
X-Rays, Lab Exams, Tests?
Eye Doctor Visits?
Glasses/Contacts and Cleaning Supplies?
Prescriptions?
Dental Expenses?
Total: Regular Expenses*
Divided by Number of Paychecks You Receive Each Year ÷ by 52
÷ by 26
= Amount to Deposit Into Your Eligible Account =
Each Pay Period
Don’t Forget—Which Medical Option You Choose Will Affect How Much
You Pay Out-Of-Pocket
How Much Do You Spend Out-of-Pocket During an Average Year
On… Amount
Last Year’s Tax Credit-Eligible Daycare Expenses?
Day Care/Preschool Programs?
After-School Programs?
Babysitters?
Adult Day Care?
Plus Any Fee Increases?
Total: Regular Expenses*
Divided By Number of Paychecks You Receive Each Year ÷ by 52
÷ by 26
= Amount to Deposit Into Your Dependent Care =
Account Each Pay Period
* Each account has speciic maximum limits you are eligible to contribute each year pre-
tax. Refer to more information about each account in this guide to be sure you limit your
election to those maximums if applicable.
! FSA Reminder: “Use It or Lose It”
Carefully consider your FSA contribution amounts; unused funds are not rolled
over and are forfeited to the plan. However, the FSAs offer a grace period where
you may incur claims through March 15 of the following year and claim against
the previous year’s funds. All claims must be submitted for reimbursement by
March 31 of the following plan year.
15
How Much Do You Spend Out-of-Pocket During an Average Year
on… Amount
Routine Doctor Visits?
Hospital Services?
X-Rays, Lab Exams, Tests?
Eye Doctor Visits?
Glasses/Contacts and Cleaning Supplies?
Prescriptions?
Dental Expenses?
Total: Regular Expenses*
Divided by Number of Paychecks You Receive Each Year ÷ by 52
÷ by 26
= Amount to Deposit Into Your Eligible Account =
Each Pay Period
Don’t Forget—Which Medical Option You Choose Will Affect How Much
You Pay Out-Of-Pocket
How Much Do You Spend Out-of-Pocket During an Average Year
On… Amount
Last Year’s Tax Credit-Eligible Daycare Expenses?
Day Care/Preschool Programs?
After-School Programs?
Babysitters?
Adult Day Care?
Plus Any Fee Increases?
Total: Regular Expenses*
Divided By Number of Paychecks You Receive Each Year ÷ by 52
÷ by 26
= Amount to Deposit Into Your Dependent Care =
Account Each Pay Period
* Each account has speciic maximum limits you are eligible to contribute each year pre-
tax. Refer to more information about each account in this guide to be sure you limit your
election to those maximums if applicable.
! FSA Reminder: “Use It or Lose It”
Carefully consider your FSA contribution amounts; unused funds are not rolled
over and are forfeited to the plan. However, the FSAs offer a grace period where
you may incur claims through March 15 of the following year and claim against
the previous year’s funds. All claims must be submitted for reimbursement by
March 31 of the following plan year.
15
