Life can be taxing enough – so get real relief by contributing to one or both of the separate flexible spending accounts administered by MyCafeteriaPlan. When you use an FSA, your tax-free dollars go a lot farther to pay eligible healthcare expenses for you and your family or dependent care expenses for your kids or dependent parent. This special pre-tax account helps you pay for out of pocket healthcare expense. You simply set aside money each pay period to meet eligible expenses incurred during the plan year. You may choose to contribute a specific amount deducted from your paycheck up to $5,000.00 per year. You also have the option to have your FSA reimbursement directly deposited into your personal banking account.
*If you are a Value Plan participant, the County will match your FSA contribution dollar for dollar up to a total match of $1,000.00
Medical FSA
You have two options as to how your claims are filed:
Auto-file (or Streamline) – MyCafeteriaPlan will automatically process your FSA claims if you participate in Montgomery County’s medical, dental and/or vision plans. Claims for medical, dental and/or vision expenses from plans other than Montgomery County plans will have to be filed manually as well as over-the-counter (OTC) products. *Due to Healthcare Reform, over-the-counter drugs will only be FSA reimbursable if prescribed by a doctor: effective January 1, 2011
Manual - If you prefer to file your healthcare claims manually you will be required to contact myCafeteriaPlan to opt out of Auto-file. You will be required to complete a medical claim form and submit a copy of your medically eligible receipt via email, fax or mail.
Dependent Care FSA
You can use your dependent care account to pay for expenses incurred in caring for your eligible dependents while you work. Under the plan eligible dependents include children under age 13 who qualify as a dependent for federal tax purposes or your spouse/elderly parent/or other qualified dependent who his physically or mentally incapable of self-care. To participate you must be single – or married with a spouse who works or is a full-time student. You must also have custody or your eligible children. Dependent care expenses include day care centers, nursery schools, and licensed in-home care. Annual limits if single or filing a joint tax return are $5,000.00, if married filing separately $2,500.00. If you participate in the dependent care FSA, you cannot claim the same expenses on your tax return at year end.
Use it or Lose it
Keep in mind that the IRS has strict rules regarding FSA use due to the great tax advantage it offers. The most important rule is whatever money you do not use you lose. Expenses must be incurred by the end of the plan year (June 30) to qualify for reimbursement.
www.MyCafeteriaPlan.com
800-865-6543 — Customer Service
937-865-6502 — Fax
claims@MyCafeteriaPlan.com — email
FSA Medical Claim Form
FSA Dependent Care Claim Form
FSA Direct Deposit Form
FSA Orthodontia Claim Form
Decision Support Calculator
Dependent Care Worksheet
Medical Reimbursement Worksheet
