Page 19 - Optima Tax EE Guide 01-20 CA w Kaiser

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 Important FSA Rules
account(s) will be funded with tax-free dollars using FSA Plan Year: January 1 - December 31
convenient payroll deductions.

Only expenses for services incurred during the plan year are Because FSAs can give you a significant tax
eligible for reimbursement from your accounts. If you are advantage, they must be administered
using your debit card, you must save your receipts, just in according to specific IRS rules:
case Igoe needs a copy for verification. Also, all receipts
should be itemized to reflect what product or service was Health Care FSA
purchased. Credit card receipts are not sufficient per IRS Up to $500 of any unspent funds remaining
guidelines. in your account at the end of the plan year
will carry-over to the next plan year, and
Igoe| Health Care FSA unspent funds above $500 will be forfeited.
This plan is used to pay for expenses not covered under
your health plans, such as deductibles, coinsurance, copays
and expenses that exceed plan limits. Employees may defer Dependent Care FSA
up to $2,750 pre-tax per year. Eligible expenses include: Unused funds will NOT be returned to you or
carried over to the following year. You must

file claims by December 31st of each FSA
plan year.

Coinsurance, Medical and Dental Eye Exams, Tip!
Copays and Prescriptions and Eyeglasses We encourage you to plan ahead to make
Deductibles Orthodontia and Lasik Eye the most of your FSA dollars. If you are
Surgery
unable to estimate your health care and
dependent care expenses accurately, it is
Go to www.fsastore.com to shop for FSA-eligible products,
and for a list of eligible expenses. better to be conservative and underestimate
rather than overestimate your expenses.
Igoe| Dependent Care FSA
This plan is used to pay for eligible expenses you incur for
child care, 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, Flexible Spending Accounts
after school programs, http://video.burnhambenefits.com/fsa/
summer camps (under age
13), preschool

Employee Benefits 19