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 plan includes a grace period option, you will have 2 and ½ months extra to incur and claim against unused funds in the new plan year. Keep in mind that remaining balances after the grace period is exhausted will be forfeited under the use-it-or-lose-it rule.

Contribution Limits

• 2024: $3,200
• 2025: Limits have not been released.

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.

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
• FSA Voucher