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This document is an election form for employees of Ball State University to enroll in the Flexible Benefits Plan for Healthcare and Dependent Care Flexible Spending Accounts (FSA). It outlines the

How to fill out flexible benefit plan healthcare

How to fill out Flexible Benefit Plan (Healthcare & Dependent Care FSA)

1. Obtain the Flexible Benefit Plan form from your employer or the HR department.
2. Read the instructions carefully to understand the benefits provided.
3. Gather necessary information, including your personal details and dependent information.
4. Determine the amount you want to contribute to your Healthcare and Dependent Care FSAs for the plan year.
5. Fill in the contribution amounts in the appropriate sections of the form.
6. Provide documentation for eligible healthcare and dependent care expenses if required.
7. Review your form for accuracy before submission.
8. Submit the completed form to your HR department or through the designated platform.

Who needs Flexible Benefit Plan (Healthcare & Dependent Care FSA)?

1. Employees looking to save on federal taxes by setting aside pre-tax dollars for healthcare expenses.
2. Individuals with dependent care costs, such as daycare or after-school programs, that wish to use pre-tax funds to pay for these services.
3. Families with ongoing medical expenses and those seeking to manage childcare costs.

People Also Ask about

What is the flex benefits FSA?

A flexible spending account (FSA) is a spending account that lets you set aside money on a pre-tax basis to pay for qualified expenses. With an FSA, a portion of your paycheck is deposited in one or more account on a pre-tax basis. You can then use these funds to pay for out-of-pocket eligible expenses.

How does an FSA work?

A Flexible Spending Account (FSA, also called a “flexible spending arrangement”) is a special account you put money into that you use to pay for certain out-of-pocket health care costs. You don't pay taxes on this money. This means you'll save an amount equal to the taxes you would have paid on the money you set aside.

What's the difference between FSA and dependent care FSA?

Although both are Flexible Spending Accounts, a Healthcare FSA is very different from a Dependent Care FSA. A Healthcare FSA is to help you pay for healthcare expenses for you and your dependents. A Dependent Care FSA is to help you pay for childcare and elder care expenses so you can continue to work.

What is a dependent care FSA?

A Dependent Care FSA (DCFSA) is used to pay for childcare or adult dependent care expenses that are necessary to allow you and your spouse, if married, to work, look for work or attend school full-time.

What happens if I don't use my dependent care FSA?

The IRS has a "use-it-or-lose-it" rule. It requires that all money you put into your FSA must be used to reimburse qualified expenses incurred during that plan year. Funds that are left over after the plan year ends are forfeited.

Who is eligible for dependent care FSA?

The money in your FSA can only be used for expenses for: A dependent who is younger than 13. A spouse who is unable to work and care for themselves. Another adult dependent who is unable to care for themselves and for whom you claim the dependent exemption on your taxes8.

For pdfFiller’s FAQs

What is Flexible Benefit Plan (Healthcare & Dependent Care FSA)?

A Flexible Benefit Plan, which includes Healthcare and Dependent Care Flexible Spending Accounts (FSA), allows employees to set aside pre-tax earnings for eligible medical or dependent care expenses, reducing their overall taxable income.

Who is required to file Flexible Benefit Plan (Healthcare & Dependent Care FSA)?

Employees who wish to take advantage of the tax savings associated with setting aside pre-tax dollars for eligible healthcare or dependent care expenses must participate in and file for the Flexible Benefit Plan.

How to fill out Flexible Benefit Plan (Healthcare & Dependent Care FSA)?

To fill out the Flexible Benefit Plan, employees typically need to complete a benefits enrollment form provided by their employer, indicating the amount to be contributed for the plan year and providing any necessary supporting documentation for expenses.

What is the purpose of Flexible Benefit Plan (Healthcare & Dependent Care FSA)?

The purpose of a Flexible Benefit Plan (Healthcare & Dependent Care FSA) is to allow employees to save on taxes by using pre-tax dollars for qualified medical expenses and dependent care services, enhancing their financial ability to manage these costs.

What information must be reported on Flexible Benefit Plan (Healthcare & Dependent Care FSA)?

The information that must be reported includes the total amounts contributed to the FSA, claims submitted for reimbursement, and any remaining balance at the end of the plan year, along with required documentation for specific expenses.