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Summary Plan Description & Summary of Material Modifications

medical/rx/dental/vision Flexible Spending Accounts (FSAs) Flexible Spending Accounts (FSAs)

May 14, 2024

Flexible Spending Account (FSA)

A flexible spending account (FSA) allows you to set aside pretax dollars to pay for eligible healthcare and non-medical dependent care expenses. You can contribute pretax dollars to our account each pay period. Because you pay no federal or Social Security taxes on the money you set aside in FSA’s, you pay less in taxes. 

When you enroll, you will elect the amount you want deducted equally from each paycheck throughout the year.

What you need to know:

• If you have a Health Savings Account, you cannot enroll in the General Purpose FSA, but you can enroll in the limited purpose FSA to pay for eligible dental and vision expenses. Opening an HSA does not affect your eligibility to open a dependent care FSA.
• You must elect your FSA's during open enrollment - this is a one-time election and does not roll over into the next year. You can, however, enroll or make changes if you experience a Qualifying Life Event
• An FSA is not a savings account. Any unused money in your account at the end of the year is forfeited (use it or lose it). Estimate expenses carefully – you cannot change your contribution after the enrollment period unless you have a Qualifying Life Event

General Purpose FSA (not available if contributing to an HSA):

• Contribution limit: $3,050 per year
• Reimburses qualified medical, prescription, dental and vision expenses, including deductibles, copays and coinsurance, for you and your eligible family members
• Pay for eligible expenses with the provided FSA debit card

Limited Purpose FSA (if contributing to an HSA):

• Contribution limit: $3,050 per year

  “I’m afraid of losing money.”

  It’s a realistic worry.

  The funds you set aside typically expire at the end of the calendar year meaning you must use the money or lose it.
  
  That's why, in mid-November, it's wise to check the balance in your medical FSA. If you have unused funds, check out what qualifies as eligible expenses so you may  spend the your remaining account balance and not lose!.

• Reimburses only eligible dental and vision care expenses
• Pay for eligible expenses with the provided FSA debit card

Dependent Care FSA:

• Contribution limit: $5,000 per year or $2,500 if married and filing separate tax returns
• Covers eligible day care and elder care expenses so you and your spouse can work or attend school
• Does not cover healthcare expenses

To File Claims:

• To file claims incurred after 1/1/2024:
  Mail:
  
  MyChoice Accounts
  MSC 345475
  P.O. Box 105168
  Atlanta, GA 30348-5168
  
  Fax: (855) 883-8542
  Email: claims@mychoiceaccounts.com
  Upload: MyChoice Mobile App

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