Page 17 - Moonwell Studios Benefit 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 Important FSA Rules
be funded with tax-free dollars using convenient payroll Because FSAs can give you a significant tax
deductions. Only expenses for services incurred during the advantage, they must be administered
plan year are eligible for reimbursement from your accounts. according to specific IRS rules:
If you are using your debit card, you must save your receipts,
just in case Health Equity needs a copy for verification. Also, Health Care FSA
all receipts should be itemized to reflect what product or The Healthcare FSA includes a 2.5 month
service was purchased. Credit card receipts are not sufficient grace period after the plan year to incur
per IRS guidelines. claims. After the grace period, unused funds
will be forfeited. Use it or lose it.
Health Care FSA
This plan is used to pay for expenses not covered under your Important Note for HSA Medical
health plans, such as deductibles, coinsurance, copays and Participants:
expenses that exceed plan limits. Employees may defer up to If you enroll in the HSA Medical Plan and
$2,750 pre-tax per year. Eligible expenses include: 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 Plan.

Dependent Care FSA
Coinsurance, Medical and Dental Eye Exams, Unused funds will NOT be returned to you or
Copays and Prescriptions and Eyeglasses and carried over to the following year. You must
Deductibles Orthodontia Lasik Eye file claims by December 31st of each plan
Surgery year.

Go to www.fsastore.com to shop for FSA-eligible products, Tip!
and for a list of eligible expenses. If you are unable to estimate your health care

and dependent care expenses accurately, it is
Dependent Care FSA better to be conservative and underestimate
This plan is used to pay for eligible expenses you incur for rather than overestimate your expenses.
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:

Educational Video
Licensed nursery schools, Adult daycare facilities Flexible Spending Accounts
qualified childcare centers, http://video.burnhambenefits.com/fsa/
after school programs,
summer camps (under age
13), preschool

Employee Benefits 17