Page 16 - Aspiration Partners Employee Benefits Guide – California

Our Health Care FSA and Dependent Care FSA are
administered through Igoe Administrative Services. 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) Important FSA Rules
will be funded with tax-free dollars using convenient payroll
deductions. Only expenses for services incurred during the Because FSAs can give you a significant tax
plan year are eligible for reimbursement from your advantage, they must be administered
accounts. If you are using your debit card, you must save according to specific IRS rules:
your receipts, just in case Igoe needs a copy for verification.
Also, all receipts should be itemized to reflect what product Health Care FSA
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
Igoe - Health Care FSA allow the return of unused account balances
This plan is used to pay for expenses not covered under at the end of the plan year, and remaining
your health plans, such as deductibles, coinsurance, copays balances cannot be carried forward to a
and expenses that exceed plan limits. Employees may defer future plan year.
up to $2,750 pre-tax per year. Eligible expenses include:

$500 Carry-Over
Up to $500 of any unspent funds remaining
in your account at the end of the plan year
will carry-over to the next plan year, and
Coinsurance, Medical and Dental Eye Exams, unspent funds above $500 will be forfeited.
Copays and Prescriptions and Eyeglasses
Deductibles Orthodontia and Lasik Eye Dependent Care FSA
Surgery Unused funds will NOT be returned to you or
carried over to the following year. You must
Go to www.fsastore.com to shop for FSA-eligible products,
and for a list of eligible expenses. file claims by January 31st of each plan year.

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:

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