1. Flexible Spending Accounts “Bank on a Tax Break”
Administered by
CBIZ Payroll

2. Section 125 of IRC allows “tax-free” savings with Flexible Spending Accounts
Health Care FSA
Dependent Care FSA
Limited FSA

3. “USE- IT OR LOSE- IT RULE”
IS THERE ANY RISK?
“USE- IT OR LOSE- IT RULE”
You must use all the money in your FSA during the plan year or risk forfeiting it after the end of the plan year

4. How do I get reimbursed from my FSA?
Complete and sign a claim form
List expenses, and attach itemized bills or receipts
Mail or Fax your claim to CBIZ
Reimbursement Checks mailed to your home address OR
Direct Deposited into your bank account

5. What is an Eligible Receipt?
Receipts submitted for reimbursement require the following:
Date of Service
Type of Service
Provider’s Information
Your Portion of the Bill
No Credit/Debit Card Receipts or Copies of Cancelled Checks are Accepted. This is an IRS guideline.

6. Or you may use the Take Care Card… An easy way to get reimbursed from your FSA!
Each participant receives a Take Care Card
You may use the Take Care Card to pay for qualified medical, dental, vision & dependent care expenses
Funds moved from your FSA to pay provider
No Out-Of-Pocket!!

7. Where can the Take Care Card be used?
Doctor or Dentist Offices
Pharmacies or Drug Stores
Vision Care Providers
Hospitals, Labs & X-ray Facilities
Dependent Care Providers
The Card is “smart” and only works with eligible providers

8. What else should I know about using the Take Care card?
Important: The process is not 100% paperless!
YOU MUST SAVE ALL YOUR RECEIPTS!
The IRS requires you to submit copies of your receipts whenever your expense is not a “co-pay match” with your health plan or an expense purchased through a “No Receipt Retailer”
A current list of “No Receipt Retailers” can be found at
You will be informed in your monthly statement about any purchases “pending” approval—Be sure to submit documentation within 30-days to avoid having your Take Care Card deactivated
Your card limit is your annual election

9. What happens when you use the card?
Employees pay expenses with the Take Care Card
Monthly statement noting “approved” and any “pending” debit card transactions
Go to to view pending transactions and to reconcile account
FAX documentation for “pending” approval
Repay “ineligible” items by credit card or bank debit via website or mail check to repay
Card is “turned-off” if documentation not sent within 30-days of statement date
Card is “turned-on” when “pending” issue is cleared

10. What happens if you don’t use the card?
Pay expense from personal funds
FAX or mail claim form with copies of itemized bills or receipts
Reimbursed weekly - Every Friday
Check or Direct Deposit

11. The Health Care FSA

12. Expenses eligible for reimbursement from the Health Care FSA
Deductibles/Co-payments
Acupuncture
Alcoholism & Drug Abuse Treatments
Childbirth Classes
Chiropractor
Contact Lenses & Solutions
Dental Expenses
Eye Exams & Eye Glasses
Hearing Aides & Batteries
Laser Surgery for Vision
OTC Drugs (Pain Relievers, Antacids, Cold & Allergy)
Orthodontia
Prescription Sunglasses
Psychiatric Care
Smoking Cessation Programs
Medical Related Transit Exp.
Weight Loss Programs-Doctor Prescribed for Obesity

13. Why use the Healthcare FSA?
Provides a tax break you could not get otherwise
Most of us don’t have enough “deductible” expenses
To deduct expenses total must exceed 7.5% of Annual Gross Income (on personal income tax)
Remember not all “medical” expenses are tax deductible
Cosmetic surgery, teeth whitening procedures
Health club expenses, exercise equipment for general health
Vitamins and supplements taken for general health

14. How much can I save by using the Health Care FSA?
When you add your savings from Federal, State and FICA, you save up to 30% by “pre-taxing”
For every $100 you spend in Doctor Visits, Prescriptions, Over the Counter Medicines, Orthodontia, Contact lenses, glasses and much more, you can save up to $30.00 (even more if you are in a higher tax bracket!)

15. What else should I know about the Health Care FSA?
Maximum annual contribution limit is set by your Employer
All expenses must be incurred during the plan year
“Date of Service” is key—the actual date you received the service--not when you paid the bill
You may only claim reimbursement after the expense has been incurred—not in advance

16. For Dependent Child Care & Senior / Elder Care Expenses
The Dependent Care FSA
For Dependent Child Care & Senior / Elder Care Expenses

17. Qualifying expenses
Include costs you pay for dependent care which allow you (and your spouse if you are married) to work and earn income
Expenses for Children under 13 years of age
Baby-sitting Expenses
Day Care Centers & Preschool (pre-K only)
Summer Day Camp (no over-night camp)
Care for Adult Dependent*(over age 13)
Care for disabled dependent, in-home nursing care
Senior day care & Eldercare expenses
*Dependent must qualify as your dependent for Federal income tax purposes

18. How much can I save using the Dependent Care FSA?
Lets assume for example you have $5,000 annual Dependent Care costs
Your tax savings could be up to $1,500 if in the lowest tax bracket, over $2,000 in the higher brackets!

19. What else should I know about the Dependent Care FSA?
Maximum Annual Contribution limit $5,000
$5,000 is the limit “Per Family”
$2,500 if married filing separately
Your spouse must also be working, a Full-time student, or disabled to qualify
Must report Tax ID# or SS# of care provider
Compare the Dependent Care FSA vs. Tax Credit

20. The Limited FSA
For Vision & Dental Expenses

21. Why use the Limited FSA?
Allows employees in the HSA to use pre-tax dollars for dental and vision expenses.
Provides a tax break you could not get otherwise.
Maximum annual contribution limit is set by your Employer
All expenses must be incurred during the plan year
“Date of Service” is key—the actual date you received the service--not when you paid the bill

22. What else do I need to know about the Flexible Spending Account?
To control your risk-Be conservative--Only calculate expenses you know you will incur
Annual election-no changes allowed unless you have a qualifying family status change
Save your itemized bills and receipts for all purchases
You will have online access 24 hours a day to your

23. Questions? Please contact CBIZ Flex with any questions about your FSA
Phone: , Option 4
Fax: