Page 16 - 2020 Dawson Benefits Guide
P. 16
Contribution
Account
Use For
Debit Card Healthcare Most medical, dental, and vision $2,750 annual maximum
The WageWorks FSA debit card is FSA care expenses not covered under
an easy way to keep cash in your the plan (e.g., copays, deductibles,
pocket while using your FSA. Many orthodontia expenses, lasik surgery,
and prescription eyewear). May be
payments made with the card are used for eligible dependents regardless
approved automatically, so no of whether they are covered under a
further paperwork is required. Both DAWSON beneit plan.
healthcare and dependent care Dependent Dependent day care expenses (e.g., $5,000 annual maximum;
$2,500 if married and
expenses may be paid with the Care FSA daycare, after school programs for iling separate tax returns
children under age 13, or elder
debit card. care programs for your legal tax
dependents) so you and your spouse
If WageWorks cannot determine can work or attend school full-time.
the use of your debit card is for
an eligible expense, a request for
substantiation will be sent which will
require you to submit a copy of the
receipt which clearly indicates the
nature of the expense. The reason An Example of How the FSA Plans Work
for this request is to prove funds Semi-Monthly Deductions Without FSA With FSA
were used to pay eligible medical, Gross Monthly Pay $1,000 $1,000
dental, and vision care expenses. Dependent Day Care Spending ($104.00)
Failure to respond to substantiation Account Contribution
requests will result in the suspension Medical Spending Account ($25.00)
of your debit card. Contribution
Taxable Pay $1,000 $871
Less FICA Taxes* ($77) ($66)
Less Federal Income Tax* ($200) ($174)
Take Home Pay $724 $631
Cost of Daycare ($104)
Cost of Un-Reimbursed Medical ($25)
Expenses
Discretionary Income $595 $631
* Please note the tax rate used in this example is an estimate. Actual tax rate will vary based
on local and state taxes in your area.
16 2020 Benefits Guide
Account
Use For
Debit Card Healthcare Most medical, dental, and vision $2,750 annual maximum
The WageWorks FSA debit card is FSA care expenses not covered under
an easy way to keep cash in your the plan (e.g., copays, deductibles,
pocket while using your FSA. Many orthodontia expenses, lasik surgery,
and prescription eyewear). May be
payments made with the card are used for eligible dependents regardless
approved automatically, so no of whether they are covered under a
further paperwork is required. Both DAWSON beneit plan.
healthcare and dependent care Dependent Dependent day care expenses (e.g., $5,000 annual maximum;
$2,500 if married and
expenses may be paid with the Care FSA daycare, after school programs for iling separate tax returns
children under age 13, or elder
debit card. care programs for your legal tax
dependents) so you and your spouse
If WageWorks cannot determine can work or attend school full-time.
the use of your debit card is for
an eligible expense, a request for
substantiation will be sent which will
require you to submit a copy of the
receipt which clearly indicates the
nature of the expense. The reason An Example of How the FSA Plans Work
for this request is to prove funds Semi-Monthly Deductions Without FSA With FSA
were used to pay eligible medical, Gross Monthly Pay $1,000 $1,000
dental, and vision care expenses. Dependent Day Care Spending ($104.00)
Failure to respond to substantiation Account Contribution
requests will result in the suspension Medical Spending Account ($25.00)
of your debit card. Contribution
Taxable Pay $1,000 $871
Less FICA Taxes* ($77) ($66)
Less Federal Income Tax* ($200) ($174)
Take Home Pay $724 $631
Cost of Daycare ($104)
Cost of Un-Reimbursed Medical ($25)
Expenses
Discretionary Income $595 $631
* Please note the tax rate used in this example is an estimate. Actual tax rate will vary based
on local and state taxes in your area.
16 2020 Benefits Guide
