Page 15 - Omega Benefits Guide

Flexible Spending Accounts

Omega Construction provides you the opportunity to pay for out-of-pocket medical, dental, vision and
dependent care expenses with pretax dollars through Flexible Spending Accounts administered by
ProBenefits. You must enroll/re-enroll to participate in the December 1 – November 30 plan year. If you
are enrolled in the Core UHC Medical plan and open an HSA account, you are not eligible for the full
Health Care FSA. However, you still have the opportunity to enroll in a limited FSA that can be used to
reimburse out-of-pocket dental and vision expenses only.

A Health Care FSA is used to reimburse out-of-pocket medical expenses incurred by you and your
dependents. The annual maximum that you can contribute to the Health Care FSA is $2,550 for 2017.
There is a $25 per month minimum contribution.

A Dependent Care FSA is used to reimburse expenses related to care of eligible dependents (children
ages 12 and under, or dependent disabled adults) while you and your spouse work. The annual
maximum that you can contribute to the Dependent Care FSA is $5,000 for married filing jointly or single
and $2,500 for married filing separately.

Contributions to your FSA come out of your paycheck pretax. This means that you don’t pay federal
income tax, Social Security taxes, or state and local income taxes on the portion of your paycheck you
contribute to your FSA. You should contribute the amount of money you expect to pay out-of-pocket for
eligible expenses for the plan period. There is a $500 rollover benefit per year for your Health Care FSA.
Any remaining funds, over $500, will be forfeited after the last day of the plan year. If you do not use the
money you contributed to your Dependent Care FSA, it will not be refunded to you or carried forward to
a future plan year. This is the IRS “Use It or Lose It” rule.

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