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WHERE CAN I USE MY FLEX DOLLARS?

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Flexible Spending Account (FSA) & Dependent Care Spending

Overview

Allows participants to pay for eligible healthcare (Medical, Dental, and

Vision) and/or dependent care expenses with pre-tax dollars. Over-the-

counter medicines are not reimbursable under an FSA without a

prescription from a physician. May not change election during the

calendar year, except due to change in family status.

Deferral Limits

Health Care: Maximum contribution $2,600 annually

Minimum contribution $500 annually

Dependent Care: Max $5,000 annually ($2,500 if you are married and

filing separately) Minimum contribution $500 annually

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WHAT IS A DEPENDENT CARE ACCOUNT (DCA)?

WHERE CAN I USE MY DEPENDENT CARE FLEX DOLLARS?

INCREASE YOUR TAKE HOME PAY WITH AN FSA!

HOW MUCH CAN I CONTRIBUTE?

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U N D E R S TA N D I N G

YOUR FSA PLAN