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Flexible Spending Accounts

ASI Flexible Spending Account Claim Form 
 
 

Flexible Spending Accounts Overview

There are two types of Flexible Spending Accounts: Health Care and Dependent Care. The accounts are completely separate but are similar in that they allow you to set aside before-tax dollars to pay eligible health and dependent care expenses that other benefit plans don't cover.

The Accounts can help you pay for expenses that are predictable. They may offer savings, but you should plan carefully. Amounts left in either account at the end of the plan year (July 1 - June 30) are forfeited due to IRS Regulations.

Here’s how they work:

  • You authorize payroll deductions before income and employment taxes are withheld; and
  • When you have eligible expenses, you file your claims for reimbursement - from the tax free money you’ve set aside.

Although the two accounts are similar, they are different. Careful planning of the dollar amounts deposited into your accounts is encouraged, because any remaining balance at the end of the plan year cannot be refunded, transferred or carried forward.

 

Contribution Amounts

  • You may contribute a minimum of $120 per plan year and a maximum $4,000 in a Health Care FSA.
  • You may contribute a minimum of $135 per plan year and a maximum of $5,000 in a Dependent Care FSA.  Additionally, due to IRS regulations you are limited to $5,000 in a calendar year.

This guide represents a summary of benefits provided by the City of Scottsdale to benefited employees. Every effort has been made to report information accurately. All information, including the amount of any benefit and employee eligibility of benefits, is subject to and governed by the terms and conditions of the applicable policy or plan documents. In all cases where any of the information provided in this guide differs from the amount of benefit actually provided by the policy or plan, the terms of the legal documents will control.

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