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FSA CLAIM Wormhole Health Care (HCA) Dependent Care (DORA) Reimbursement Accounts YOU MAY COMPLETE THIS FORM BEFORE PRINTING BY USING YOUR TAB KEY TO MOVE FROM FIELD TO FIELD (SHIFT + TAB WILL MOVE

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How to fill out dependent care fsa

01

Step 1: Gather the necessary documents required to fill out the dependent care FSA. This may include receipts, invoices, and other proof of expenses related to dependent care.

02

Step 2: Obtain the dependent care FSA form from your employer or benefit provider.

03

Step 3: Fill out the form, providing accurate and detailed information about the dependent care expenses you incurred.

04

Step 4: Attach the required documents as evidence for the expenses claimed.

05

Step 5: Review the completed form and attached documents for any errors or missing information.

06

Step 6: Submit the filled-out form and supporting documents to your employer or benefit provider.

07

Step 7: Keep a copy of the submitted form and documents for your records.

08

Step 8: Follow up with your employer or benefit provider to ensure the proper processing and reimbursement of your dependent care FSA.

Who needs dependent care fsa?

01

Dependent care FSA is beneficial for individuals or families who have qualifying dependents, such as children or disabled adults, and require financial assistance in covering the costs of their care.

02

It is particularly useful for working parents who incur dependent care expenses while they are employed or seeking employment.

03

Employees who have access to a dependent care FSA as part of their employee benefits package can take advantage of the tax advantages and savings it offers.

04

However, eligibility for a dependent care FSA may vary depending on the employer's specific policies and requirements.

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What is dependent care fsa?

Dependent Care FSA (Flexible Spending Account) is a pre-tax benefit account that helps employees pay for eligible dependent care expenses, such as daycare, preschool, summer day camp, and more.

Who is required to file dependent care fsa?

Employees who have eligible dependents and wish to use pre-tax dollars to pay for dependent care expenses are required to file Dependent Care FSA.

How to fill out dependent care fsa?

Employees can fill out the Dependent Care FSA form provided by their employer and submit it with required documentation to the FSA administrator.

What is the purpose of dependent care fsa?

The purpose of Dependent Care FSA is to help employees save money on eligible dependent care expenses by using pre-tax dollars.

What information must be reported on dependent care fsa?

Employees must report their eligible dependent care expenses and provide documentation, such as receipts or invoices, when filing Dependent Care FSA.

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