Flexible Spending Account

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    The simple way to save for health and dependent care expenses PayFlex® Flexible Spending Account (FSA)

    Health care FSA

    • You can contribute pretax dollars from your paycheck, up to theInternal Revenue Service (IRS) limit of $2,700.*
    • Your full contribution is available at the start of the plan year to payfor eligible health care expenses. It covers you, your spouse and/oryour tax dependents for:
      -Copays, coinsurance and deductibles
      -Dental expenses like orthodontia, crowns and bridges
      -Vision expenses like LASIK eye surgery, glasses and contacts
      -Prescription drugs and over-the-counter (OTC) items**

    Dependent care FSA

    • You can contribute pretax dollars from your paycheck, up to the IRSlimit of $5,000.*
    • Funds are for your dependent(s) age twelve or younger, or a spouseor dependent incapable of self-care.
    • Pays for eligible child and adult care expenses, such as day care,preschool and nursery school, in-home aid and more.

    Pay with ease

    We’ll show you how simple it is to pay for your eligible expenses:

    • Use the PayFlex Card®, your account debit card: When you use thePayFlex debit card (if offered), your expense is automatically paidfrom your FSA.
    • Pay yourself back: Pay for eligible expenses with cash, a check oryour personal credit card. Then submit a claim to pay yourself back.For speed, have your claims payment deposited directly into yourchecking or savings account.
    • Pay your provider: Use PayFlex’s online feature (if offered) to payyour provider directly from your account

    For additional information view member PDF flyer or visit PAYFLEX to get started.

2020 FSA forms and Information