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DEPENDENT CARE/HEALTH CARE REIMBURSEMENT ACCOUNT PLANS ENROLLMENT AUTHORIZATIONPlease type or print clearly with ballpoint pen. Return completed form to campus Benefits Officer. SEE PRIVACY NOTICE
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How to fill out dependent care fsa dcfsa

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How to fill out dependent care fsa dcfsa

01
Enroll in a Dependent Care FSA (DC FSA) during your company's open enrollment period
02
Decide how much money you want to contribute to your DC FSA for the year, keeping in mind the maximum allowed by the IRS
03
Keep copies of any receipts or documentation for eligible dependent care expenses throughout the year
04
Submit claims for reimbursement through your DC FSA provider following their specific guidelines

Who needs dependent care fsa dcfsa?

01
Employees who have dependent children under the age of 13
02
Employees who have elderly parents or other relatives who require dependent care
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Dependent Care Flexible Spending Account (DCFSA) is a pre-tax benefit that allows employees to set aside money to pay for eligible dependent care expenses, such as daycare for children or care for elderly dependents.
Employees who want to receive reimbursement for qualified dependent care expenses must file for the DCFSA. It is not required for everyone; rather, it is optional for those who have set aside funds in the account.
To fill out a DCFSA claim, employees should provide details about the care provider, the dates of service, the amount spent, and submit the required documentation, such as receipts, through their employer's benefits portal.
The purpose of DCFSA is to provide tax savings to employees by allowing them to use pre-tax dollars for qualifying dependent care expenses, thereby reducing their taxable income.
Information that must be reported includes the name, address, and taxpayer identification number of the care provider, dates of services, and the total amount spent on eligible expenses.
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