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MAIL TO: PayFlex Systems USA, Inc. P.O. Box 3039 Omaha, NE 68103-3039 (866) 321-0964 FAX TO: PayFlex Systems USA, Inc. (402) 231-4310 (No Cover Page Required) Page 1 of Health/Dependent Care Flexible.

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Do you need an FSA? A health care FSA can be useful for people with any level of health costs. If you have predictable, ongoing medical expenses during the year, or regular over-the-counter spending, using pretax dollars for those costs lowers your bottom line.

If your out-of-pocket medical bills typically amount to $221 a month or more — or roughly $2,650 a year — consider contributing the maximum to your FSA. If your medical expenses are generally low, contributing the total of your approximate copays, dental and vision expenses for next year is probably enough.

Eligible expenses include health plan co-payments, dental work and orthodontia, eyeglasses and contact lenses, and prescriptions. This type of FSA is offered by most employers. It covers medical, dental, vision, and pharmacy expenses. If you have a Standard FSA, you are ineligible for contributing to an HSA.

What is it? A limited-purpose flexible spending account (FSA) is a special account that lets you set aside money — before it is taxed — to help pay for eligible dental and vision expenses.

HSAs have substantial tax advantages, so much so that some use them as retirement plans, alongside their 401(k) or IRA accounts. Contributions to an HSA are made with pretax dollars. This means that you won't pay income tax on the money that you put directly into your HSA and you'll save on income taxes for the year.

Disadvantages of an FSA The primary disadvantage is that, typically, most FSA accounts have a “use or lose it” feature, which means you need to spend all of your FSA funds before the end of the plan's year. If you fail to do so, you'll forfeit your FSA funds.

The summary plan description is an important document that tells participants what the plan provides and how it operates. It provides information on when an employee can begin to participate in the plan and how to file a claim for benefits.

Here are the maximum contribution amounts for 2023: FSA maximum — $3,050 or lower, depending on employer. HSA maximum, individual — $3,850. HSA maximum, family — $7,750.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232