Flexible Spending
Accounts
ProBusiness, A Division of ADP National Accounts
It Pays to Participate!
FSAFSA
®
A Division of ADP National Accounts
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What Are Flexible Spending Accounts? What Are Flexible Spending Accounts? And Why Should I Participate?And Why Should I Participate?
Flexible Spending Accounts (FSA) allow you to set aside pre-tax dollars to pay for certain health and dependent care expenses.
Flexible Spending Accounts (FSA) are a “tax free” benefit through the IRS
Flexible Spending Accounts (FSA) are a great way to reduce your taxable income
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TaxTax Savings Example Savings Example
Without FSA With FSA
Gross Monthly Salary $3,000 $3,000
Pre-tax Contribution to Reimbursement Account - 0 - - $ 300
Taxable Salary $3,000 $2,700
Less: FICA & Federal Tax* $1,050 $ 945
Take Home Pay $1,950 $1,755
After Tax Expenses - $ 300 - 0 -
Net Take Home Pay $1,650 $1,755
Increase in Monthly Spendable Income N/A $ 105
Increase in Annual Spendable Income N/A $ 1260
* State tax savings are available in most states but are excluded from this example.
Your tax savings may vary based on your tax bracket and income.
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Your Flexible Spending Account ComponentsYour Flexible Spending Account Components
Health Care Spending AccountUn-reimbursed or uncovered eligible health care expenses (copayments, Rx, dental/vision, deductibles)
Dependent Care Spending Account Eligible dependent care including child care, disabled spouse & incapacitated parent expenses
Premium Payment PlanPay for your share of employer-sponsored insurance premiums
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How Do Flexible Spending Accounts Work?How Do Flexible Spending Accounts Work?
Calculate and decide on your plan year election Complete an enrollment form authorizing deduction on a pre-tax
basis from each paycheck. Your contributions will be placed into your account throughout the plan year
As you incur* expenses, submit and the necessary receipts anda claim form to ProBusiness
ProBusiness will reimburse you for your expenses
* Incurred means a Plan Participant has been provided services that gives rise to an expense, not when the Plan Participant is formally billed, charged for, or pays for the services.
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Planning is Important!Planning is Important!
Be conservative when establishing your plan contributions
Target 80% of your estimated expenses
Only services incurred during the plan year are eligible
You have a grace period to submit claims after the plan year is over
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Changing Your Flexible Spending Account Changing Your Flexible Spending Account ElectionElection
Once enrolled and your period of coverage begins, your election is irrevocable except in these instances:
During open enrollment
You experience a qualified family status change
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What Are Qualified Status Changes?What Are Qualified Status Changes?
Marital status change
Number of dependents
Employment status
Dependent satisfies or ceases to satisfy the requirements for unmarried dependents
Residence
Adoption Assistance
Health CareReimbursement
Account
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A Division of ADP National Accounts
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Health Care Expense EligibilityHealth Care Expense Eligibility
Orthodontia treatment
Rx co-payments
Acupuncture
Chiropractic
Contraceptive Prescriptions
Psychiatrist/Counseling
Durable Medical Equipment
Over the Counter (OTC) Drugs or Medicines used for medical care
Deductibles
Co-insurance
PPO, HMO or EPOco-payments
Dental expenses
Eye glasses, contact lenses
Contact solutions, cleaners
Diabetic supplies
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Ineligible Health Care ExpensesIneligible Health Care Expenses
Cosmetic Treatments
Cosmetic Prescriptions
Teeth Bleaching
Health Club Memberships
Herbs and Vitamins
Dietary Supplements
Union Dues or Insurance Premiums
* This is only a partial list of health care expenses that are not eligible for reimbursement from your Health Care Reimbursement Account.
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Health Care Spending Account ClaimsHealth Care Spending Account Claims
To receive reimbursement, your documentation must include:
Date of service
Diagnosis or description of Service
Dollars outstanding after insurance or other payment (money you owe)
Dependent CareReimbursement
Account
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A Division of ADP National Accounts
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Can I Use The Can I Use The Dependent Care Account?Dependent Care Account?
YES, as long as...
You & your spouse are gainfully employed or looking for work
OR
You are a single, working parentOR
Your spouse is a full-time student for at least 5 months during the calendar year
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Eligible Dependent Care ExpensesEligible Dependent Care Expenses
Care through kindergarten
If the provider cannot separate the cost of care from the cost of schooling, the entire amount is reimbursable.
If the provider separates the cost of care from the cost of schooling, only the cost of care is reimbursable.
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Eligible Dependent Care ExpensesEligible Dependent Care Expenses
Care before & after normal school hours
Beginning with 1st grade, it is mandatory that the cost of care and the cost of schooling be separated. Only the cost of care is reimbursable. Care before & after normal school hours qualifies.
Day camps
Au pair or nanny expenses(including their associated payroll taxes)
Day care for a disabled spouse or dependent parent that lives with you
ReimbursementProcess
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A Division of ADP National AccountsA Division of ADP National Accounts
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Reimbursement ProcessReimbursement Process
Submit a Claim Form:
For Health Care: include Explanation Of Benefits statements, co-payment receipts, “super bills” that include description of service, date(s) of service and out of pocket costs (copies are recommended)
For Dependent Care: include receipts for expenses or have the care provider sign the claim form. The provider’s tax ID number or social security number must be provided on the claim form.
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Don’t Forget . . .Don’t Forget . . .
If you are submitting a paper claim . . .
To sign the claim form
To indicate the $ amount being requested
Supporting claim documentation – the IRS does not allow: cancelled checks
credit card receipts
balance-due statements
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Paper Claim Reimbursement ProcessPaper Claim Reimbursement Process
Fax your signed reimbursement form & documentation to us @ 800-269-5231
Reimbursements will occur according to the reimbursement schedule in your welcome packet
Questions? Visit our Web Site: www.probusiness.com
E-Mail us at: [email protected]
Call us: 1-800-269-0020
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Enroll Using the World Wide Web!Enroll Using the World Wide Web!
Access the ProBusiness’ Web site from work or home at www.probusiness.com
Refer to the step-by-step on-line instructions
Once enrolled you will receive: Confirmation your data was received
A welcome kit with a confirmation statement and reimbursement schedule following open enrollment
Enroll in your
Flexible Spending Account Plans today!
It Pays to Participate!
FSAFSA
®
A Division of ADP National Accounts