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Martin County Board of County Commissioners I Employee Benefit Highlights 12021 F'Aa, Flexible Spending Accounts (Continued) - FSA Guidelines �- -, • Employee may carry over$550 of unused Health Care FSA funds into the next plan year after a plan year ends and all claims have been HERE'S HOW IT WORKS! filed (only if the employee re-enrolls the next year). Dependent Care funds cannot be carried over. An employee earning$30,000 elects to place$1,000 into a Health • When a plan year ends and all claims have been filed,all unused Care FSA.The payroll deduction is$83.33 based on a monthly pay funds with the exception of the$550 rollover for the Health Care period schedule.As a result,health care expenses are paid with tax- FSA will be forfeited and not returned. free dollars,giving the employee a tax savings of$227. • Employee can enroll in an FSA only during the Open Enrollment With a Health Without a Health period,a Qualifying Event,or New Hire Eligibility period. Care FSA Care FSA • Money cannot be transferred between FSAs. Salary $30,000 $30,000 • Reimbursed expenses cannot be deducted for income tax purposes. FSA Contribution -$1,000 -$o • Employee and dependent(s)cannot be reimbursed for services they Taxable Pay $29,000 $30,000 have not received. Estimated Tax -$6,568 $6,795 • Employee and dependent(s)cannot receive insurance benefits or 22.bs%=15%+7.bs%FICA any other compensation for expenses reimbursed through an FSA. After Tax Expenses -$0 -$1,000 • Domestic Partners are not eligible as Federal law does not recognize Spendable Income $22,432 $22,205 them as a qualified dependent. 41) Tax Savings Filing a Claim Claim Form A completed claim form along with a copy of the receipt as proof of the expense can be submitted by mail or fax.The IRS requires FSA participants to Please Note:Be conservative when estimating health care and/or dependent maintain complete documentation,including copies of receipts for reimbursed care expenses.IRS regulations state that any unused funds which remain in expenses,for a minimum of one(1)year. an FSA,after a plan year ends and after all claims have been filed,cannot be returned or carried forward to the next plan year with the exception of the S550 Debit Card carry over that may be allowed for the Health Care FSA.This rule is known as FSA participants will automatically receive a debit card for payment of eligible "use-it or loseit." expenses.If member has a BenefitsWorkshop Health Reimbursement Account debit card,the Health Care FSA and Dependent Care FSA available balances will be added to the debit card.Health care expenses will be deducted first BenefitsWorkshop I Customer Service:(888)537-3539 from the Health Care FSA balance and then will be deducted from the HRA. www.benefitsworkshop.com I Email:info@benefitsworkshop.com This way forfeitable money is used first.With the card,most qualified services and products can be paid at the point of sale versus paying out-of-pocket and requesting reimbursement.The debit card is accepted at a number of health care providers and facilities,and most pharmacy retail outlets.BenefitsWorkshop may request supporting documentations for expenses paid with a debit card. Failure to provide supporting documentation when requested,may result in suspension of the card and account until funds are substantiated or refunded back to the County.This card will not expire at the end of the benefit year. Please keep the issued card for use next year.Additional or replacement cards may be requested,however,a small fee may apply. 96 14 0 2016,Gehring Group,Inc.,All Rights Reserved