Flexible Spending Account (Health FSA) is an IRS-approved program to help you save taxes and reimburse yourself for out-of-pocket medical expenses not covered under your medical plan. Your employer has chosen the $550 Roll-Over Option for your Health FSA plan. This option allows you the opportunity to roll over up to $550 of unclaimed Health FSA funds into the following plan year. Keep in mind that balances more than $550 will be forfeited under the use-it-or-lose-it rule.

Your maximum contribution amount for 2022 is $2,850.

Highlights

• Contributions are automatically deducted from your paycheck on a pre-tax basis, which helps reduce your taxable income and increase your spendable income.
• Your full election will be available to you at the beginning of the plan year.
• Be conservative – any money left in your account at the end of the plan year with be forfeited.
• Use your benefits card to pay for qualified expenses upfront so you don’t have to spend money out of pocket.
• Keep all receipts in case you need to substantiate a claim for tax purposes.

Health Plans Must Cover OTC COVID-19 Tests

Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) are laws passed which include requiring group health coverage to cover the costs of over-the counter (OTC) COVID-19 diagnostic tests (up to $12.00). The Department of Labor (DOL) and the Internal Revenue Service (IRS) has provided additional guidance to prevent fraud and abuse, the insurer or plan provider, may require an attestation, the OTC COVID-19 test was purchased by the participant, beneficiary, or enrollee for personal use, not for employment purposes, has not been (and will not be) reimbursed by another source, and is not for resale.

PLAN INFORMATION

FORMS

• Medical FSA Claim Form
• Medical FSA Claim Form – Spanish
• Direct Deposit Authorization Form
• Benefits Card Application
• Letter of Medical Necessity Claim Form