Page 19 - 2016 Enrollment
P. 19
American Food & Vending
Flexible Spending Accounts
(FSA) Important Enrollment
Note
Flexible Spending Account (FSA) You must actively elect any lexible
spending account (FSA) funds every year.
Use lexible beneits to bring home more of your paycheck. If you had an FSA last year you must
An FSA allows you to set aside a portion of your salary, before taxes, re-elect the beneit this year. We cannot
automatically re-enroll you with last year’s
to pay for qualiied medical or dependent care expenses. Because election. Employees are not allowed to
that portion of your income is not taxed, you end up with more change the amounts of deductions during
money in your pocket. Any unused funds at the end of the year will the year unless they have a change in
be forfeited. If you terminate employment, only expenses incurred family status.
before your termination date are eligible expenses under the FSA.
Changes to your FSA What Documentation Is
Needed?
If you choose to elect the CDHP medical plan with HSA, you will no
longer be able to elect the Healthcare FSA. FSA contributions are not Documentation for medical expenses,
allowed along side HSA contributions. You may however, still elect to required by the IRS, includes a third-
contribute to the Dependent Care FSA. party receipt containing the following
information:
Healthcare Date service was received or
You can use your FSA to pay for copays, healthcare deductibles, purchase made
and other out-of-pocket expenses which are not covered under your Description of service or item
beneit plans. This includes out-of-pocket expenses for dental and purchased
vision care as well.
Dollar amount (after insurance, if
Dependent Care applicable)
You may use your dependent care spending account to pay for Prescription drug number or name
daycare expenses for a dependent under the age 13. Reimbursement
through the dependent care account will be allowed only up to the
current account balance. Eligible expenses include:
If your spouse is enrolled in a High
Payments to a licensed daycare or nursery school Deductible plan and contributing to
an HSA, you cannot participate in the
Before and after school care or summer day care Healthcare FSA, you will only be eligible
2016 Maximum Contributions to participate in the Dependent Care FSA.
Healthcare $2,550
Dependent care $5,000
19
Flexible Spending Accounts
(FSA) Important Enrollment
Note
Flexible Spending Account (FSA) You must actively elect any lexible
spending account (FSA) funds every year.
Use lexible beneits to bring home more of your paycheck. If you had an FSA last year you must
An FSA allows you to set aside a portion of your salary, before taxes, re-elect the beneit this year. We cannot
automatically re-enroll you with last year’s
to pay for qualiied medical or dependent care expenses. Because election. Employees are not allowed to
that portion of your income is not taxed, you end up with more change the amounts of deductions during
money in your pocket. Any unused funds at the end of the year will the year unless they have a change in
be forfeited. If you terminate employment, only expenses incurred family status.
before your termination date are eligible expenses under the FSA.
Changes to your FSA What Documentation Is
Needed?
If you choose to elect the CDHP medical plan with HSA, you will no
longer be able to elect the Healthcare FSA. FSA contributions are not Documentation for medical expenses,
allowed along side HSA contributions. You may however, still elect to required by the IRS, includes a third-
contribute to the Dependent Care FSA. party receipt containing the following
information:
Healthcare Date service was received or
You can use your FSA to pay for copays, healthcare deductibles, purchase made
and other out-of-pocket expenses which are not covered under your Description of service or item
beneit plans. This includes out-of-pocket expenses for dental and purchased
vision care as well.
Dollar amount (after insurance, if
Dependent Care applicable)
You may use your dependent care spending account to pay for Prescription drug number or name
daycare expenses for a dependent under the age 13. Reimbursement
through the dependent care account will be allowed only up to the
current account balance. Eligible expenses include:
If your spouse is enrolled in a High
Payments to a licensed daycare or nursery school Deductible plan and contributing to
an HSA, you cannot participate in the
Before and after school care or summer day care Healthcare FSA, you will only be eligible
2016 Maximum Contributions to participate in the Dependent Care FSA.
Healthcare $2,550
Dependent care $5,000
19
