Brookstone School - 2023 Benefits Guide

Flexible Spending Account (FSA)

2023 IRS Contribution Limit

Medical FSA - $2,850* Carry over $570 of unused funds Dependent Care FSA - $5,000 • Married Filing Separately - $2,500 • Single or Married Filing Jointly - $5,000

Obtain a complete list of eligible and ineligible expenses for FSAs by accessing www.irs.gov. Under “Search Forms and Publications,” enter “502” for the health care plan and “503” for the dependent care plan.

What is the Benefit?

A Flexible Spending Account (FSA) can save you up to 25% on your eligible health care and/or dependent care expenses by using pre-tax dollars. This plan runs January through December.

Your Eligibility

To be eligible for enrollment in any of the FSAs listed you must work 25+ hours a week and be at least 21 years of age.

*Unused Funds

Any unused funds up to $570 will be forfeited after

90 days of the plan year ending.

Accounts Offered Health Care FSA - medical, dental, vision and pharmacy expenses Dependent Care FSA - care for your child, disabled spouse, or other dependent who is physically or mentally incapable of self-care. Medical expenses for your dependent are not eligible for reimbursement under the Dependent Care FSA.

5 BROOKSTONE SCHOOL 2023 BENEFITS GUIDE

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