Page 17 - TCW_Benefit Guide_2019 FINAL

FLEXIBLE SPENDING ACCOUNTS (FSAs)

With an FSA, your eligible out-of-pocket medical, dental, or vision expenses and/
or dependent care expenses may be paid with pre-tax dollars. Essentially, you
get to keep the federal and state taxes you would otherwise be charged for these
expenses. You also avoid paying Social Security and Medicare taxes and state and
local taxes on these amounts in most locations.

TCW provides three FSA options:

• Health Care Flexible Spending Account (HCFSA) (to go with the PPO and HMO plans)
• Limited Purpose Health Care FSA (LPFSA) (to go with the CDHP w/HSA plan)
• Dependent Care Flexible Spending Account (DCFSA)

HEALTH CARE FSA (HCFSA)
Contribute pre-tax dollars from your paycheck, up to $2,650 (for year 2019). You can then
be reimbursed (by check or direct deposit) for eligible medical, dental and vision benefits
for yourself and eligible dependents. You will have access to the full amount at the start
of the plan year. For information about eligible health care expenses, you may refer to IRS
Publication 502 (type IRS Publication 502 into your search engine).

SAMPLE ELIGIBLE EXPENSES:
• Copays, coinsurance and deductibles
• Dental expenses like orthodontia, crowns and bridges
• Vision expenses like LASIK laser eye surgery, glasses and contact lenses
• Prescription drugs

LIMITED PURPOSE HEALTH CARE FSA (LPFSA)
If you enroll in the CDHP w/HSA medical plan, you are not eligible to participate in the full
Health Care FSA. Instead, you may enroll in the Limited Purpose Health Care FSA (LPFSA)
due to IRS rules.

The LPFSA is used only for eligible dental and vision expenses. (The HSA already provides
you a pre-tax benefit for qualified medical expenses.) You can elect up to $2,650 for year 2019
into the LPFSA.

SAMPLE ELIGIBLE EXPENSES:
• Out-of-pocket dental costs FYI: AUTOMATIC SUBMITTAL OF HEALTH
• Orthodontia services CARE FSA CLAIMS
• Glasses If you elect a TCW medical plan or participate
• Contact lenses in TCW’s Delta Dental Plan, your expenses
• LASIK surgery may be “streamlined.” When your claims are
processed by Anthem or Delta, any eligible FSA
expense that you have to pay out of your own
pocket will automatically be routed to PayFlex for
reimbursement if you participate in the HCFSA.
If you participate in the LPFSA, you will need to
logon to your account and instruct Payflex to use
your HSA or LPFSA funds or pay the remaining
balance to the provider yourself. You may only
need to file FSA claims for your vision expenses

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