Page 16 - WesternU Sample Guide

Flexible Spending

Accounts

Flexible Spending Accounts (FSAs) are special tax-advantaged
accounts used to pay for eligible out-of-pocket health care and
dependent care expenses. If elected, your account(s) will be funded Important FSA Rules
with tax-free dollars using convenient payroll deductions. Only Because FSAs can give you a significant tax
expenses for services incurred during the plan year are eligible for advantage, they must be administered according to
reimbursement from your accounts. If you are using your debit card, specific IRS rules:
you must save your receipts, just in case [FSA Administrator] needs a

copy for verification. Also, all receipts should be itemized to reflect
Health Care FSA
what product or service was purchased. Credit card receipts are not
sufficient per IRS guidelines. You must forfeit any money left in your account(s)
after your expenses for the year have been
reimbursed. The IRS does not allow the return of
Health Care FSA
unused account balances at the end of the plan
This plan is used to pay for expenses not covered under your health
year, and remaining balances cannot be carried
plans, such as deductibles, coinsurance, copays and expenses that
exceed plan limits. Employees may defer up to $2,700 pre-tax per forward to a future plan year.
year. Eligible expenses include:
Important Note for HSA Medical Participants:
If you enroll in the HSA Medical Plan and contribute
to your HSA account, you may only participate in
the Health Care FSA to cover out-of-pocket Dental

and Vision expenses through the Limited Purpose
Coinsurance, Medical and Dental Eye Exams, Plan.
Copays and Prescriptions and Eyeglasses and
Deductibles Orthodontia Lasik Eye

Surgery
Dependent Care FSA

Unused funds will NOT be returned to you or
Dependent Care FSA
carried over to the following year. You must file
This plan is used to pay for eligible expenses you incur for child care, claims by December 31, 2019.
or for the care of a disabled dependent, while you work. Employees
may defer up to $5,000 pre-tax per year. Eligible expenses include:

Licensed nursery schools, Adult daycare facilities Educational Video
qualified childcare centers, after
school programs, summer camps Flexible Spending Accounts
(under age 13), preschool