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® A Division of ADP National Accounts FSA It Pays to Participate ! Flexible Spending Accounts ProBusiness, A Division of ADP National Accounts What Are Flexible Spending Accounts? And Why Should I Participate?

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flexible spending accounts


A Division of ADP National Accounts


It Paysto Participate!

Flexible SpendingAccounts

ProBusiness, A Division of ADP National Accounts

what are flexible spending accounts and why should i participate
What Are Flexible Spending Accounts? And Why Should I Participate?
  • Flexible Spending Accounts (FSA) allow you to set aside pre-tax dollars to pay for certain health and dependent care expenses.
  • Flexible Spending Accounts (FSA) are a “tax free” benefit through the IRS
  • Flexible Spending Accounts (FSA) are a great way to reduce your taxable income
tax savings example
Tax Savings Example

Without FSA With FSA

Gross Monthly Salary $3,000 $3,000

Pre-tax Contribution to Reimbursement Account - 0 - - $ 300

Taxable Salary $3,000 $2,700

Less: FICA & Federal Tax* $1,050 $ 945

Take Home Pay $1,950 $1,755

After Tax Expenses - $ 300 - 0 -

Net Take Home Pay $1,650 $1,755

Increase in Monthly Spendable Income N/A $ 105

Increase in Annual Spendable Income N/A $ 1260

* State tax savings are available in most states but are excluded from this example.

Your tax savings may vary based on your tax bracket and income.

your flexible spending account components
Your Flexible Spending Account Components
  • Health Care Spending AccountUn-reimbursed or uncovered eligible health care expenses (copayments, Rx, dental/vision, deductibles)
  • Dependent Care Spending AccountEligible dependent care including child care, disabled spouse & incapacitated parent expenses
  • Premium Payment PlanPay for your share of employer-sponsored insurance premiums
how do flexible spending accounts work
How Do Flexible Spending Accounts Work?
  • Calculate and decide on your plan year election
  • Complete an enrollment form authorizing deduction on a pre-tax basis from each paycheck. Your contributions will be placed into your account throughout the plan year
  • As you incur* expenses, submit and the necessary receipts anda claim form to ProBusiness
  • ProBusiness will reimburse you for your expenses

* Incurred means a Plan Participant has been provided services that gives rise to an expense, not when the Plan Participant is formally billed, charged for, or pays for the services.

planning is important
Planning is Important!
  • Be conservative when establishing your plan contributions
  • Target 80% of your estimated expenses
  • Only services incurred during the plan year are eligible
  • You have a grace period to submit claims after the plan year is over
changing your flexible spending account election
Changing Your Flexible Spending Account Election

Once enrolled and your period of coverage begins,

your election is irrevocable except in these instances:

  • During open enrollment
  • You experience a qualified family status change
what are qualified status changes
What Are Qualified Status Changes?
  • Marital status change
  • Number of dependents
  • Employment status
  • Dependent satisfies or ceases to satisfy the requirements for unmarried dependents
  • Residence
  • Adoption Assistance
health care


A Division of ADP National Accounts

Health Care



health care expense eligibility
Orthodontia treatment

Rx co-payments



Contraceptive Prescriptions


Durable Medical Equipment

Over the Counter (OTC) Drugs or Medicines used for medical care



PPO, HMO or EPOco-payments

Dental expenses

Eye glasses, contact lenses

Contact solutions, cleaners

Diabetic supplies

Health Care Expense Eligibility
ineligible health care expenses
Ineligible Health Care Expenses
  • Cosmetic Treatments
  • Cosmetic Prescriptions
  • Teeth Bleaching
  • Health Club Memberships
  • Herbs and Vitamins
  • Dietary Supplements
  • Union Dues or Insurance Premiums

* This is only a partial list of health care expenses that are not eligible for reimbursement from your Health Care Reimbursement Account.

health care spending account claims
Health Care Spending Account Claims

To receive reimbursement, your

documentation must include:

  • Date of service
  • Diagnosis or description of Service
  • Dollars outstanding after insurance or other payment (money you owe)


A Division of ADP National Accounts

Dependent Care



can i use the dependent care account
Can I Use The Dependent Care Account?

YES, as long as...

  • You & your spouse are gainfully employed or looking for work OR
  • You are a single, working parentOR
  • Your spouse is a full-time student for at least 5 months during the calendar year
eligible dependent care expenses
Eligible Dependent Care Expenses

Care through kindergarten

  • If the provider cannot separate the cost of care from the cost of schooling, the entire amount is reimbursable.
  • If the provider separates the cost of care from the cost of schooling, only the cost of care is reimbursable.
eligible dependent care expenses16
Eligible Dependent Care Expenses
  • Care before & after normal school hours
    • Beginning with 1st grade, it is mandatory that the cost of care and the cost of schooling be separated. Only the cost of care is reimbursable. Care before & after normal school hours qualifies.
  • Day camps
  • Au pair or nanny expenses(including their associated payroll taxes)
  • Day care for a disabled spouse or dependent parent that lives with you


A Division of ADP National Accounts

A Division of ADP National Accounts



reimbursement process
Reimbursement Process

Submit a Claim Form:

  • For Health Care: include Explanation Of Benefits statements, co-payment receipts, “super bills” that include description of service, date(s) of service and out of pocket costs (copies are recommended)
  • For Dependent Care: include receipts for expenses or have the care provider sign the claim form. The provider’s tax ID number or social security number must be provided on the claim form.
don t forget
Don’t Forget . . .

If you are submitting a paper claim . . .

  • To sign the claim form
  • To indicate the $ amount being requested
  • Supporting claim documentation – the IRS does not allow:
    • cancelled checks
    • credit card receipts
    • balance-due statements
paper claim reimbursement process
Paper Claim Reimbursement Process
  • Fax your signed reimbursement form & documentation to us @ 800-269-5231
  • Reimbursements will occur according to the reimbursement schedule in your welcome packet
  • Questions?
    • Visit our Web Site: www.probusiness.com
    • E-Mail us at: bsa@probusiness.com
    • Call us: 1-800-269-0020
enroll using the world wide web
Enroll Using the World Wide Web!
  • Access the ProBusiness’ Web site from work or home at www.probusiness.com
  • Refer to the step-by-step on-line instructions
  • Once enrolled you will receive:
    • Confirmation your data was received
    • A welcome kit with a confirmation statement and reimbursement schedule following open enrollment


A Division of ADP National Accounts


It Paysto Participate!

Enroll in your

Flexible Spending Account Plans today!