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Limited Flexible Spending Account (FSA) Benefits Card 59589840 (9/19)//* Effective displease PRINT CLEARLY * This information is mandatory. Enrollment may be delayed if fields with an asterisk are
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How to fill out your flexible spending accounts
How to fill out your flexible spending accounts
01
Determine how much money you want to contribute to your flexible spending account for the year.
02
Understand what expenses are eligible for reimbursement through your flexible spending account.
03
Keep all receipts and documentation for expenses paid for with your flexible spending account.
04
Submit claims for reimbursement according to your flexible spending account provider's guidelines.
05
Monitor your account balance and deadlines for submitting expenses throughout the year.
Who needs your flexible spending accounts?
01
Individuals who have predictable healthcare or dependent care expenses throughout the year.
02
Those who want to save money on eligible expenses by using pre-tax dollars.
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What is your flexible spending accounts?
Flexible spending accounts (FSAs) are accounts that allow you to set aside pre-tax money to pay for eligible out-of-pocket medical and dependent care expenses.
Who is required to file your flexible spending accounts?
Employees who have opted to contribute to an FSA through their employer's benefits package are required to file their flexible spending accounts.
How to fill out your flexible spending accounts?
To fill out your flexible spending accounts, you need to keep track of your eligible expenses and submit reimbursement requests according to your FSA plan guidelines.
What is the purpose of your flexible spending accounts?
The purpose of flexible spending accounts is to help individuals save money on eligible out-of-pocket medical and dependent care expenses by setting aside pre-tax dollars.
What information must be reported on your flexible spending accounts?
You must report eligible expenses, reimbursement requests, and any changes to your FSA contribution amount on your flexible spending accounts.
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