Page 17 - Enrollment Guide
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Example of How the Plan Works
An employee makes $3,000 each month and decides to participate in
the FSA. As a result, their insurance premiums, healthcare, and daycare
expenses are paid with tax-free dollars. Before the plan year begins, the
employee determines how much he or she wants to reduce his or her pay
to fund the lexible spending account(s).
Without With
FSA Plan FSA Plan
Gross monthly earnings $3,000 $3,000
Health and day care expenses -$500 -$500
Adjusted earnings after FSA withholding N/A $2,500
FICA, federal, state taxes -$660 -$525
Net earnings $1,840 $1,975
With the FSA, this family was able to increase take-home pay by $135 per
month or $1,620 annually. They were also able to use the money in the
FSA accounts to pay for health and dependent care expenses.
Flexible Spending Accounts Calculator
The table below helps you determine your annual election based on the
amount you want to set aside each pay period. Determine the amount
you wish to set aside for each pay period, then multiply the number of
pay periods by the amount you elect to set aside. The result is the annual
election you want to set aside in your FSA. Remember there are two FSAs
so if you wish to put money in both accounts, you will need to determine
the annual election for each FSA.
Annual
Deduction # of Pay Periods Election *
Healthcare FSA (1) $__________ x A =
Dependent Care FSA (2) $__________ x A =
* $2,550 maximum for healthcare
A Weekly = 52; bi-weekly = 26; semi-monthly = 24
(1) $2,550 annual maximum
(2) $5,000 annual maximum
Benefit Guide 2016
Example of How the Plan Works
An employee makes $3,000 each month and decides to participate in
the FSA. As a result, their insurance premiums, healthcare, and daycare
expenses are paid with tax-free dollars. Before the plan year begins, the
employee determines how much he or she wants to reduce his or her pay
to fund the lexible spending account(s).
Without With
FSA Plan FSA Plan
Gross monthly earnings $3,000 $3,000
Health and day care expenses -$500 -$500
Adjusted earnings after FSA withholding N/A $2,500
FICA, federal, state taxes -$660 -$525
Net earnings $1,840 $1,975
With the FSA, this family was able to increase take-home pay by $135 per
month or $1,620 annually. They were also able to use the money in the
FSA accounts to pay for health and dependent care expenses.
Flexible Spending Accounts Calculator
The table below helps you determine your annual election based on the
amount you want to set aside each pay period. Determine the amount
you wish to set aside for each pay period, then multiply the number of
pay periods by the amount you elect to set aside. The result is the annual
election you want to set aside in your FSA. Remember there are two FSAs
so if you wish to put money in both accounts, you will need to determine
the annual election for each FSA.
Annual
Deduction # of Pay Periods Election *
Healthcare FSA (1) $__________ x A =
Dependent Care FSA (2) $__________ x A =
* $2,550 maximum for healthcare
A Weekly = 52; bi-weekly = 26; semi-monthly = 24
(1) $2,550 annual maximum
(2) $5,000 annual maximum
Benefit Guide 2016
