FSA General Overview

By participating in this program, you can direct money from your paycheck into an account to pay for certain health care and dependent care expenses. The money you place in this account is not taxed; it is subtracted from your pay before taxes are calculated. This means you pay less tax and you have pre-tax money to spend on health care and dependent care expenses.

Health care expenses for you and your eligible dependents that are typically not covered under your medical, dental or vision plans, such as co-pays and deductibles, can be paid from a Health Care FSA. A Limited Health Care FSA is available to employees enrolled in the Health Savings Account Option and can be used to reimburse you for dental, vision and out-of-network preventive care expenses.

If you currently pay for day care for your children or adult dependents, you can use the dependent care account to reimburse yourself for these expenses.

How the Plan Works

Estimate your family's annual health and/or dependent care expenses, and enroll, electing the amount to be withheld for the plan year. It is important to be conservative in your estimates, as any money you do not spend during the plan year will be forfeited.

When you incur a qualified expense, you submit a claim form and proof of payment to the plan administrator, ASI, who will then issue you a reimbursement check or direct deposit the reimbursement into your bank account. You may also chose to use a debit card to pay for qualified health care expenses at the time of purchase. Claim forms and direct deposit sign-up forms can be downloaded from the ASI website. Please note that debit card purchases may still require follow-up documentation to be submitted to ASI. For more information on the debit card, click here.

You will have until April 30 of the following year to submit claims to ASI for eligible expenses incurred during the calendar year. Any expenses that are not claimed by April 30 of the following year will be forfeited.

Review the Participant Plan Information document for more information.

Health Care FSA

Co-pays, deductibles, eligible medical, dental and vision expenses not covered by health plans, over-the-counter drugs (with a prescription), and illness-related transportation expenses for you and your eligible dependents can be paid for through a Health Care FSA. Only expenses related to dental, vision or out-of-network preventive care services for you and your eligible dependents can be paid for through the Limited Health Care FSA. Health care expenses are limited to $5,000 per year.

For a more detailed overview of qualifying and non-qualifying health care expenses, refer to the Participant Plan Information document.

Dependent Care FSA

The Dependent Care FSA plan can be used for day care expenses incurred while you and your spouse work or attend school full-time. A dependent's medical expenses can not be claimed through the Dependent Care FSA. You can claim these expenses through your Health Care FSA.

The IRS limit for dependent care expenses is $5000 per family ($2,500 if married filing separate Federal Income Tax returns) per year. You must provide a tax ID number or Social Security Number for your day care center or private provider for tax purposes. Your provider cannot be one of your own children under the age of 18.

The information you will read here and in other FSA plan documentation refers to "dependent" and "qualifying person"; these terms are interchangeable and may differ from the definition of dependent for other health care programs.

For purposes of claiming expenses under the FSA Dependent Care plan, a qualifying person must be:

• Your dependent child who was under age 13 when the care was provided, for whom you have custody of more than 50% of the year, and who you can claim as an exemption on your Federal Income Tax return; or
• Your dependent (child older than age 13, spouse, parent or other family member for whom you have custodial responsibility) who is physically or mentally unable to care for himself or herself, shares the same residence with you AND has income less than the federal exemption amount.

For a more detailed overview of qualifying and non-qualifying expenses, refer to the Participant Plan Information document. You may also refer to Internal Revenue Service Publication 503 or contact your tax advisor for additional information.

 

Changes to Elections

Changes to your elections are not allowed during the calendar year, except for qualifying life events (e.g., birth of a child or employment status changes). You must request FSA changes within 31 days of a Qualified Life Event change. Refer to the Participant Plan Information document for additional information on Qualified Life Event changes.