Page 18 - Kate Somerville Benefits Guide 2020 CA FINAL

FINANCIAL SAVINGS

Flexible Spending Accounts

The Flexible Spending Account (FSA) allows employees to set aside pre-tax dollars for unreimbursed, qualified health care and
child care expenses. The money that is deposited into your FSA comes directly from your gross pay, which reduces your taxable
income. There are two separate accounts and enrollment is completely optional.

HEALTH CARE FSA
You may set aside up to $2,750 per year; these funds may be used during the plan year (January 1, 2020 to December 31, 2020).
Use the FSA to pay yourself back for out-of-pocket medical, dental and vision expenses and for expenses that your plan doesn’t
cover. Transportation and other travel costs for medical care may also be covered. Please note that over-the-counter medications,
without a prescription, are not considered an FSA eligible expense. Most importantly—always keep your receipts!
Eligible expenses include:
• Coinsurance, Copays and Deductibles
• Medical and Prescriptions
• Dental and Orthodontia
• Eye Exams, Eyeglasses and Lasik Eye Surgery

$500 ROLLOVER (FOR HEALTH CARE FSA ONLY)
Current participants can roll over up to $500 of unused health FSA funds for use in the next plan year. Here is how it works: First,
you have until the end of March 2021 (2020 run-out period) to file any remaining health FSA claims for services rendered in 2020
(January thru December 31, 2020). Any funds that can be rolled over will be calculated in April 2021. You will still have access to
these funds after April 2021, even if you do not re-enroll in the plan. If you wish to continue your enrollment, you can roll-over up
to $500, and still elect the maximum for the new plan year!

LIMITED PURPOSE HEALTH CARE FSA (FOR HSA PARTICIPANTS ONLY)
If you are enrolling in the Health Savings Account medical plan and will be participating in the funding option, you may enroll in
the limited purpose FSA plan. This plan will allow you to use the FSA funds for dental, vision and other expenses except medical.

DEPENDENT CARE FSA
Dependent care expenses are those which allow you to pay a licensed caregiver to take care of your children or an adult
dependent while you work. You may put aside up to the max of $5,000 per household ($2,500 each if your spouse also has a
Dependent Care account).

NOTE:

If you wish to continue your FSA in 2020, you
must re-enroll in the FSA, per IRS guidelines.

18 KATE SOMERVILLE EMPLOYEE BENEFITS