The Standard Benefit Guide

Flexible Spending Account

Flexible spending accounts (FSA) provide you with an important tax advantage that can help you pay health care and dependent care expenses on a pre-tax basis. As an eligible employee, you can set aside a portion of your pre-tax salary in an account, and that money is deducted from your paycheck over the course of the year. The amount you contribute to the FSA is not subject to social security (FICA), federal, state or local income taxes – effectively adjusting your annual taxable salary. HEALTH CARE REIMBURSEMENT FSA The Health Care Reimbursement FSA allows you to pay for certain IRS-approved health care expenses not covered by your insurance or reimbursed by any other benefit plan. Eligible expenses include those incurred by you, as well as your spouse and/or dependents. Typical expenses include co-pays, coinsurance, deductibles, and prescription drug expenses. For more information about eligible expenses, please refer to IRS Publication 502 available atwww.irs.gov/pub/irs-pdf/p502.pdf.

DEPENDENT CARE REIMBURSEMENT FSA The Dependent Care Reimbursement FSA allows you to use pre-tax dollars toward qualified dependent care. Care must be for a tax-dependent child under age 13 who lives with you, or a tax-dependent spouse or child who lives with you and is incapable of caring for themselves. Also, the care must be needed so that you and your spouse (if applicable) can go to work. Care must be given during normal working hours and cannot be provided by another one of your dependents. Typical expenses include baby-sitters, nursery schools, pre- schools, and day care centers.

The 2022 annual maximum contribution to the Dependent Care Reimbursement FSA is $5,000

DEPENDENT CARE FSA - “USE IT OR LOSE IT” RULE

Dependent Care Reimbursement FSA account runs on a plan year basis. The current plan year is from June 1 through May 31, 2023; claims can only be for services/expenses incurred between June 1 and May 31 of 2022. All claims MUST be submitted no later than August 15, 2022 (2 1 / 2 months Grace period from end of the FSA-Dependent Care plan year) for reimbursement. Any funds left unclaimed will be forfeited. Please make your elections carefully.

The 2022 annual maximum contribution to the Health Care Reimbursement FSA is $2,750

HEALTH CARE FSA - “CARRY OVER” RULE

With the Healthcare FSA with Carryover, you may carry over up to $500 left in your account at the end of one plan year to the next. The current FSA plan year is from June 1, through May 31, 2023. If you put at least $500 in your account, even if you don’t use it this plan year, your money will be there for you to use in the next plan year, minus any monthly service fee.

NOTE:

Applies to BOTH Healthcare and Dependent Care FSA - regarding Highly Compensated employees, Nondiscrimination testing will be performed every year. Your elected FSA amounts may decrease should the testing results discriminate in favor of highly compensated employees.

Participants MUST re-enroll in the FSA Accounts each year

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