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  • Conexis Dependent Online Reimbursment Form

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Request for Reimbursement Dependent Care Flexible Spending Account Instructions 1. Employee must complete Employee Information. 2. Complete Claim Information in its entirety. Please ensure your supporting.

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Related content

Flexible Spending Account (FSA) Sourcebook...
Eligible expenses you incur during the plan year can be reimbursed through your Dependent...
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CONEXIS Guide to ExpensesPDF - UCnet
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Funds set aside in the dependent care FSA are pretax dollars, which reduces an employee's taxable income. It's important to note that all funds in the account must be used during the plan year and cannot be rolled over to the next.

In general, the money in your FSAs can be used on your parents if they qualify as your dependent. Two types – a medical care or health care FSA and dependent care FSA – are typically offered through an employer. The dependent qualifications and use of the funds depend on which FSA you have (caregivers often have both).

The grace period begins on the first day immediately following the last day of the plan year, and in most cases, ends two months and 15 days after the end of the plan year.

The IRS also allows FSA funds to be used by any person claimed as a dependent on the FSA owner's tax return, with certain qualifications.

Get some financial relief with a dependent care FSA. Contribute up to $5,000 pretax for the plan year. After your dependents receive care, you can submit claims to pay yourself back. Just be sure to use all your funds during the plan year.

Most reimbursement checks are received within two weeks depending on your plan's payment option.

Learn more about Dependent Care Flexible Spending Accounts With a Dependent Care FSA, you can use your pre-tax funds to pay for childcare for dependents, age 12 or younger. Including daycare, preschool, and summer day camp. You can also pay for adult care for a spouse or a dependent who is incapable of self-care.

Employees can use the dependent care FSA to pay for a nanny, au pair, housekeeper, or other similar arrangement where the service provider cares for their children under age 13 to enable both the employee and the spouse to be gainfully employed.

Collect Documentation: Collect an itemized statement from your dependent care provider containing the required information (provider's name, dependent's name, service period, payment amount and care being provided, and either the provider's signature or taxpayer identification number (TIN).

The total funds you contribute annually are not immediately available at the beginning of the plan year. This is an important difference between a dependent care FSA and a health care FSA. As soon as you have money in your dependent care FSA, you can use it to pay for eligible dependent care expenses.

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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
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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