Page 14 - 2020 McLennan County Benefits Enrollment Guide

Flexible Spending Accounts
Flexible Spending Accounts (FSAs) help you save money by allowing you to pay for certain types of health care and
dependent care expenses on a pre-tax basis. You decide how much money to put aside each pay period to cover these
expenses up to the maximum. This amount is then deducted from your pay before taxes and deposited into your FSA.

ACCOUNT ANNUAL CONTRIBUTION
Medical FSA $2,750 maximum per employee
Dependent Care FSA $5,000 maximum per household*
*If you are married, filing income taxes separately from your spouse: maximum is $2,500

Medical FSA Dependent Care FSA

Eligible Health Care Expenses Eligible Dependent Care Expenses
• Prescription Medicines and Drugs • Child care provided at a daycare center or
• Hearing Aids through a private provider
• Orthopedic Goods, Prosthetic Devices • Nanny services with the care of a dependent
• Doctors • Day camps associated with the care of a
• Dentists, Orthodontics dependent
• Chiropractors • Pre-school tuition that is daycare related (price of
• Optometrists, Ophthalmologists, Opticians, tuition alone is not eligible)
Eyeglasses • Annual registration fees for daycare providers
• Over-the-counter Medicines and Drugs • After-hours care that results from working odd
(prescription needed) hours or overtime
• Chiropodists, Podiatrists • Eldercare
• Nursing and Personal Care Facilities
• Medical and Dental Laboratories Ineligible Dependent Care Expenses
• Costs claimed as a dependent care tax credit on
• Medical Services and Health Practitioners your tax return
• Ambulance Services, Equipment and Supplies
• Services provided by one of your dependents
Ineligible Health Care Expenses • Expenses for nighttime babysitting
• Cosmetic expenses such as teeth whitening, and • Your own dependents, under age 19, babysitting
hair removal or hair growth treatments • Expenses paid for schooling kindergarten and
• Massage therapy (unless accompanied with a above
doctor’s note specifying the medical necessity
and listing specific diagnosis with length of USE IT OR LOSE IT
treatment) If you do not spend all the money in your Flexible
• Health club dues Spending Accounts (or “FSAs”) during the year, IRS
• Insurance premiums of any type regulations require that you forfeit any remaining
• Weight loss programs (unless accompanied by balance. We recommend filing reimbursement for your
doctor’s note specifying medical necessity, and expenses within 30 days of the date of receipt. (If you
listing specific diagnosis with length of treatment) are unable to complete your claim for reimbursement,
you will be required to do so by the end of the Grace
Period. The Grace Period ends on December 15 at the
th
end of each plan year.)

Claims Submission Process:
Once you incur the expense, you will need to complete some paperwork and turn in your receipts to the Auditor’s office
for reimbursement. Please contact the Auditor’s office for further instructions on this process.

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