Page 38 - 2021 Mid Year Open Enrollment Guide
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Health FSA & LPFSA                                                                      Dependent Care FSA

     What are they, and should I consider enrolling?                                         The Dependent Daycare FSA offers a convenient   are unable to claim reimbursable expenses.
     The Company offers two types of accounts that may reimburse you for your eligible out-of-pocket   way to use pre-tax dollars to pay for eligible   Funds DO NOT roll over from year-to-year. Unlike
     expenses; a Health Care Flexible Spending Account (FSA) and a Limited Purpose Flexible Spending   child and elder care expenses (generally   an HSA, you must use the funds in your FSA
     Account (LPFSA).                                                                        expenses you incur so that you can work).   by December 31, 2021, or you lose them.
                                                                                             Enrollment is not automatic. You must actively   Deadline for claims submission: All claims for
     Enrollment in these accounts is never automatic. It is mandatory that you actively enroll in your FSA   enroll in the Dependent Care FSA each year.  reimbursement for the 2021 plan year must be
     each year during Open Enrollment or your new hire enrollment.                                                                   filed prior to March 31, 2022.
                                                                                             Contributions are deducted from each paycheck
                                                                                             and deposited into an account that may be   Expenses You Can Pay with a
                                      HEALTH FSA          LPFSA (LIMITED PURPOSE FSA)        accessed with a claim form.             Dependent Daycare FSA:
                                                                                                                                     Child Care (while you work) for child(ren) under
                                                                                             The Dependent Daycare FSA has IRS limitations
                              Standard PPO, Core or Buy-Up HDHP                              of $5,000 per year and further limitations for   age 13, provided by
     Which medical plan is this    (No HSA). You don’t need to be    Core or Buy-Up HDHP with HSA  certain married participants. Your taxable     • After school program
     account available for?      enrolled in a medical plan to                               income will be reduced by the amount you     • Daycare center
                                  contribute to a Health FSA.                                set aside for your FSA every pay period. It is
                                                                                             important to estimate the amount of your out-of-    • An individual who is NOT also your tax
                                                                                                                                         dependent
                                                          This health care account is only   pocket expenses carefully and plan your payroll
                                 Eligible healthcare expenses,                               contributions accordingly.                   • Summer day camp
                                                          available if you are contributing to
     What would I use this account for?  including dental, vision and  an HSA and you can only use it for
                               prescription medication expenses.                                                                     Elder Care (of your tax dependent)
                                                         eligible vision and dental expenses.  Unlike Health FSA, the Dependent Care FSA
                                                                                             can only reimburse you for amounts you have      • In your home
                                                                                             on deposit as you incur claims. You must incur     • Adult daycare
     What is the maximum amount I               $2,750 - the IRS pre-tax                     reimbursable Dependent Care expenses during
     can contribute to this account?         contribution limit as of this writing           the 2021 plan year or during your benefit period   Not Reimbursable:
                                                                                             if enrolling as a newly eligible employee.    • Health care expenses of your child or other
                                               Your entire goal amount is                                                                dependent
     When are the funds available?           available at the beginning of the               Before you enroll in Dependent
                                                   benefit period.                                                                        • Babysitting for non-work related activities
                                                                                             Day- care FSA, note this account
                                               You will forfeit amounts not                  is NOT for reimbursement of                  • Dance lessons
     What happens if I don’t use the                                                                                                      • Tutoring services
     money during the year?                   claimed for expenses incurred                  dependent health care expenses!
                                               during the benefit period.                                                                 • Field trips
                                                                                             Do not enroll in this plan unless you expect
                                                                                             to incur eligible expenses, such as daycare     • Dog walking
     Contribution allowed for Medicare    Yes               Yes, to end of year in which     services that can be substantiated with a
     enrolled?                                            Medicare enrollment first occurs
                                                                                             receipt.                                Note: For purposes of the 2021 Mid-Year Open Enrollment,
                                                                                                                                     your current Flexible Spending Account elections (if any)
                                                                                                                                     will continue through 12/31/2021 unless you modify the
                                            BFS HealthEquity 1-877-924-3967                  Also consider: Compare the Dependent    election during the mid-year enrollment period. Modifications
     Provider Contact                                                                                                                during the 2021 Mid-Year Open Enrollment will be audited
                                            BMC HealthEquity 1-866-346-5800                  Daycare FSA to the Federal dependent care   to ensure you have not adjusted your annual election for an
                                                                                             tax credit to see which approach provides you   amount lesser than what you have already received in year-
                                                                                             with the better tax advantage. In some cases,   to-date reimbursements.
     How to File FSA Claims                                                                  you may be able to split your eligible expenses
     File claims with HealthEquity. File claims with HealthEquity through March 31,          between a Dependent Care FSA and the tax
                                                                                             credit. You may wish to consult your tax advisor.
     2022 for 2021 FSA expenses incurred through December 31, 2021. Log on to
     https://www.wageworks.com/paymentoptions/ or use the WageWorks EZ
     Receipts mobile app, available in the App Store and Google Play.                        Forfeiture of Benefits
                                                                                             Be conservative in estimating health and
     To learn more visit www.wageworks.com/myfsa. There is also an online chat               dependent care expenses. You will forfeit
     option on the website and the app.                                                      amounts remaining in your Health Care and/or
                                                                                             Dependent Care FSA account(s) for which you




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