Page 12 - Guide
P. 12
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) per plan year.
Planning for any dependent child care expenses will not be affected at
all by the HRA.
Examples of FSA Eligible Expenses
Healthcare Spending Account
X Doctor’s visit copays
X Prescription drug copays
X Medical and dental deductibles
X Over-the-counter medications (with a written prescription)
X Hearing aids
X Eye glasses
X Contacts
X Contact lens solution
X Dental services
X Orthodontia
X Acupuncture
X Laser vision correction surgery
Dependent Care Spending Account
X Cost of child or adult day care *
X Nursery school
X Preschool (excluding kindergarten)
* Eligible Dependent
Tax dependent child under age 13
Tax dependent spouse, parent, or child unable to care for themselves
12
2015 Open Enrollment
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) per plan year.
Planning for any dependent child care expenses will not be affected at
all by the HRA.
Examples of FSA Eligible Expenses
Healthcare Spending Account
X Doctor’s visit copays
X Prescription drug copays
X Medical and dental deductibles
X Over-the-counter medications (with a written prescription)
X Hearing aids
X Eye glasses
X Contacts
X Contact lens solution
X Dental services
X Orthodontia
X Acupuncture
X Laser vision correction surgery
Dependent Care Spending Account
X Cost of child or adult day care *
X Nursery school
X Preschool (excluding kindergarten)
* Eligible Dependent
Tax dependent child under age 13
Tax dependent spouse, parent, or child unable to care for themselves
12
2015 Open Enrollment
