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

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










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