Flexible Spending Account
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
2020 FSA forms and Information
The Internal Revenue Service (IRS) requires PayFlex® to verify that all card purchases are eligible. Additionally, PayFlex may ask you to send documentation for a card purchase. If you receive a request, make sure to respond promptly. Your card may be suspended, and the unverified amount may be reported as taxable income. View information about keeping your PAYFLEX card active.