Flexible Spending Accounts (FSAs)

Summary

Available to full-time permanent employees including temporary faculty employed for a one-academic year contract, and permanent part-time employees including temporary faculty employed for a one-academic year contract who works 50% time.

Flexible spending accounts (FSAs) governed by the IRS Code, allows employees to have income withheld from their paychecks before taxes for eventual reimbursement of certain medical and dependent care expenses.  There are two types of FSAs:

• Medical Reimbursement Account – Employees enrolled in the medical reimbursement account estimate the amount of out-of-pocket medical expenses they will incur during the calendar year and use that amount to determine bi-weekly payroll deductions from their checks.  Upon request for reimbursement, out-of-pocket expenses are then reimbursed to the employee through a future paycheck.  The maximum annual contribution amount that can be made to a medical reimbursement account is $3,500.
• Dependent Care Reimbursement Account - Employees enrolled in the dependent care reimbursement account estimate the amount of dependent care expenses they will incur during the calendar year and use that amount to determine bi-weekly payroll deductions from their checks.  Upon request for reimbursement, out-of-pocket expenses are then reimbursed to the employee through a future paycheck.  The maximum annual contribution amount that can be made to a medical reimbursement account is $5,000.

Overview:

• FSA Fall 2008-09 Open Enrollment  Newsletter
• FSA Employee Brochure
• Summary Plan Description
• FSA Plan Document
• FSA Plan Document Amendment 1 
• FSA Plan Document Amendment 2
• Over-the-Counter Medical Expense Eligibility Guideline 

Forms:

• Enrollment Form for Medical Reimbursement Account
• Reimbursement Form for Medical Reimbursement Account (*interactive form)
• Letter of Medical Need 
• Enrollment Form for Dependent Care Reimbursement Account
• Reimbursement Form for Dependent Care Reimbursement Account (*interactive form)
• Status Change Form for Medical and Dependent Care Reimbursement Accounts

 *form can be completed online.  To submit, please download and forward via hard copy, fax, or email attachment.