Flexible Spending Accounts
FSA and Dependent Care Information – FY24 Benefits Guide
Combination FSA Information
Eligible Employees may choose to participate in the following flexible spending accounts:
A Medical Flexible Spending Account provides pre-tax reimbursement for eligible expenses. Compatible with the Roosevelt and Jefferson low deductible health plans. You have until September 14, 2023, to spend the funds or incur claims. You have until October 28, 2023, to submit claims.
A Combination Flexible Spending Account (used with a Health Savings Account only) provides pre-tax reimbursement for eligible dental and vision expenses until your health plan deductible has been met. Complete the Deductible Verification Form in order to use Combination FSA funds for medical expenses.
A Dependent Care/Day Care Spending Account provides pre-tax reimbursement for eligible childcare and adult daycare for a disabled spouse or IRS tax dependent care expenses. You have until September 14, 2023, to spend the funds or incur claims. You have until October 28, 2023, to submit claims.
Courtesy of WEX, our Flexible Spending Account Vendor.• Flexible Spending Account (FSA) Employee Guide
• Dependent Care Reimbursement Form
• Medical and Dependent Care FSA Limits
• Dependent Care Handout with Form
• Guide to the Benefits Debit Card
• How to File a Claim
• Wex Claim Form
• Mobile App Instructions
• Deductible Verification Form
• Benefits Technology & Resources
Benefits members interested in viewing video tutorials about FSA and more on the WEX Portal can click here to learn more.