Flexible Spending Account

A Flexible Spending Account (FSA) is an account you contribute pre-tax money into that you can use to pay for certain out-of-pocket health care costs. Flexible spending accounts (FSA) allow you to reduce your taxable income by setting aside pretax dollars from each paycheck to pay for eligible out-of-pocket health care and dependent care expenses for you and your family.

There are two types of FSAs:
Health Care FSA
Health Care FSAs help you stretch your budget for health care expenses for you and your dependents by allowing you to pay for these expenses using taxfree dollars. Employees may set aside up to $3,200 annually, which is deducted out of your pay throughout the year on a pre-tax basis. Funds can be used to pay for qualified health care expenses such as deductibles, medical and prescription copays, dental expenses and vision expenses.

You can use the FSA for expenses for yourself, your spouse and your dependent children — even if they are not covered under your medical or dental plan. When you submit a claim, you can be reimbursed up to your full annual election.

If you don’t use it, you won’t lose it!
You may carry over up to $640 left in your account to be carried over into the next plan year. All funds remaining over the $640 limit will be forfeited at the end of the plan year.

Dependent Care FSA
The Dependent Care FSA allows you to pay for eligible dependent care expenses with tax-free dollars while you are at work. You may set aside up to $5,000 annually in pretax dollars, or $2,500 if you are married and file taxes separately from your spouse.

Eligible expenses include those listed below:
• Care for your dependent child who is under the age of 13 that you can claim as a dependent for tax purposes
• Care for your dependent child who resides with you and who is physically or mentally incapable of caring for him/herself
• Care for your spouse or parent who is physically or mentally incapable of caring for him/herself

Any money left unspent in your Dependent Care FSA at the plan year end is forfeited.

You can elect to participate in one or both accounts.

The FSAs are administered by Flex Made Easy. Your contribution is withdrawn from each paycheck, based on your annual election amount. The total amount you elect is available immediately. You do not have to wait until you’ve contributed the money to use it.

USING YOUR FSA
Surency Flex Benefits Card:
Use your Surency Flex Benefits Card whenever you are purchasing an eligible expense. Most doctors’ offices, pharmacies, and some retailers will accept your card when paying as “credit” at checkout. Your purchase may need to be substantiated later on, so make sure to keep your receipts!

Pay With Personal Funds and Request
Reimbursement:
Pay using your own personal credit card, cash or check and keep your itemized receipt as documentation. Then log on to your online account to file for reimbursement and upload documentation.

Online and Mobile App:
You can quickly and easily submit payment requests, check your account balance and view payment status online or on your mobile device.