Page 13 - Dentons 2021 Benefits Guide Hawaii
P. 13
2021

Dentons Benefits Guide
FLEXIBLE SPENDING ACCOUNTS



Partners are not eligible to participate in the Dependent Care FSA
Healthcare or Dependent Care FSA. Pre-tax money that you deposit into the

Administered by PayFlex, flexible spending dependent care FSA pays for care expenses
accounts (FSAs) allow you to save money for dependent child(ren) up to age 13 or a
by setting aside pre-tax dollars from your dependent adult. You can set aside as much
paycheck to help pay for healthcare and/or as $5,000 per year ($2,500 if married, filing
dependent care expenses. separately). You can reimburse yourself using
tax-free dollars for things such as daycare and
These are “use it or lose it” plans. Any preschool expenses, babysitting, summer day
outstanding amounts remaining in your account camp, and dependent adult daycare expenses.
after December 31 will be forfeited. Claims for Dependent care funds cannot be used for
the current plan year must be submitted for tuition reimbursement.
reimbursement by March 31st of the following
year. To be eligible for this account, both you and
your spouse must be actively at work or looking
Healthcare FSA for work or considered a full-time student
You can deposit as much as $2,750 per year during the coverage period.
on a pre-tax basis to the healthcare FSA to be Your FSA annual election amount will be
used towards eligible medical, dental, vision, deducted on a per pay period basis, and can
and/or pharmacy expenses for you and your be drawn on as incurred. Therefore, unlike a
dependents. For a complete list of eligible healthcare FSA, the full amount of your annual
expenses, please visit the PayFlex website at election will not be available to you as of the
www.payflex.com. first day of the new plan year.

Although your FSA annual election will be The dependent care FSA can be set up
deducted on a per-pay-period basis, the full to automatically reimburse you each pay
amount of your FSA election amount will be period. For more details, contact PayFlex at
available to you as of the first day of the new 800.284.4885.
plan year.

FSA Debit Card
The PayFlex FSA debit card offers the
convenience of a pre-funded debit card that FSA Tips:
can be used for eligible purchases. When using „ Keep all receipts.
the FSA debit card for eligible purchases, please „ Check the IRS approved drug list for non-
be sure to keep all receipts for substantiation as prescription drugs.
PayFlex may still require additional information
about your purchase. „ Plan your expenses so that you use the
funds in your account by the end of the
plan year.










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