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FAQs about Flexible Spending Accounts (FSA) >
A Cafeteria Plan is a reimbursement plan governed by IRS Section 125 which allows employees to contribute a certain amount of their gross income to a designated account or accounts before taxes are calculated.
The following are guidelines established by the relevant sections of IRS code for Medical Flexible Spending Accounts and Dependent Daycare FSAs (or DCAPs).
In order to make a mid-year change of election in a participant’s medical account, the qualifying event must be permitted by the employer’s Plan and fall into one of the categories allowed by the IRS. Examples of these categories include :
If such a qualifying event occurs and the participant wishes to make a change in his or her election (consistent with the resulting gain or loss of eligibility for coverage), the plan administrator must be notified within the time limit specified by the Plan (normally within 30 days of the event). To file a Change of Status form, please see your employer.
In order to make a mid-year change of election in or termination of a participant’s dependent daycare account, the qualifying event must be permitted by the employer’s Plan and fall into one of the categories allowed by the IRS. Examples of these categories include :
Questions pertaining to cafeteria plans and flexible spending accounts (FSA)
The operative date for claim reimbursement is the service date, not the date the expense is paid. You may submit expenses billed to you before you remit payment, but you may only submit the expense once. You may not submit the expense again after it has been paid.
You can only change your election if you have a qualifying change of status event. Qualifying events include:
For more information, see IRS Account Rules.
In general, the higher your adjusted gross income, the more likely it is that you will benefit more from participating in the dependent care FSA than from taking the tax credit. Note that the amount you elect to place in your dependent care account reduces your potential tax credit.
Yes. Generally speaking, however, the benefit of the tax savings now more than outweighs the reduction in Social Security benefit after you retire. Discuss your specific financial situation with a tax consultant.
Orthodontic expenses are eligible to be reimbursed in the same way as any other medical expense. However, because such treatments generally cover an extended period of time, you have the option of scheduling monthly reimbursements rather than payment up front. In addition, if your current election does not cover the total expense of the treatment(s), it can be reimbursed over multiple plan years as long as the treatment dates occur during those years.
There at least two significant ways to benefit from an FSA. The first is by taking advantage of the tax savings. By reducing your gross income, you pay less in taxes, take home more pay and have the freedom to choose how your money is used or invested. The second benefit is the “cash flow” increase built into the medical FSA (not the dependent care FSA). This means that no matter how much money you have actually contributed to the plan at any given point, you can still be reimbursed up to your entire annual election. So a major medical expense at the beginning of the claim period can be reimbursed even though few, if any, deposits have been made into the account at that time. This applies to the medical FSA only.
Each time you are reimbursed for a claim, myCafeteriaPlan will provide a “statement of account” with your reimbursement check to let you know the balance of your remaining funds. In between statements, you can check your balance online by visiting myCafeteriaPlan’s Account Login, or by contacting a myCafeteriaPlan representative.
Using a Claim Form, you may submit your claim and supporting documentation to myCafeteriaPlan by mail, fax or electronic submission. Please visit the Contact Us page for more information.
For more detail on preparing a claim for submission, visit the Claim Submission page.
To login to your account, go to the myCafeteriaPlan Account Login page. There you will be prompted to enter a Username and Password. Once you are logged in, you can change your Username and Password and change or edit your personal information. You can also check your account balance(s) and verify the status of any claims you submitted.
Please note: When updating your personal information it is important to provide your email address for the fastest and most efficient communication.
A Cafeteria Plan is a benefit provided by your employer which allows you to contribute a certain amount of your gross income to a designated account or accounts before taxes are calculated. These accounts are for insurance premiums and medical or dependent care expenses not covered by your insurance, from which you can be reimbursed throughout the plan year or claim period as you incur the expenses. A cafeteria plan allows you to reduce your gross income, thereby reducing the amount you pay in Federal, Social Security and some State taxes – a savings of between 25% and 40% of every dollar you contribute to the plan.
Your company’s claims will be reimbursed on regularly scheduled processing days. You can obtain the processing/reimbursement schedule by contacting a myCafeteriaPlan representative or your Human Resources department. myCafeteriaPlan has a submission deadline of noon (12pm EST) on the day prior to your company’s processing date. In other words, any claims received by noon (12pm EST) the day before the processing date will be reimbursed (if eligible) on that date.
Amounts paid to a daycare provider either in or out of the home are eligible, as long as the provider is not a dependent or relative under the age of 19. Pre-school tuition is reimbursable, but tuition and expenses from grade K-12 schooling are not.
For medical accounts, any out-of-pocket expenses related to services covered by insurance, including co-pays, deductibles, prescription drugs, and out-patient elective surgery; dental, orthodontic and ophthalmologist’s fees and expenses including prescribed treatments and maintenance (such as contact solution); chiropractic, psychiatric, and psychologist’s fees and expenses; disability-related expenses; and over-the-counter (non-prescription) drugs such as pain relievers and allergy medications are eligible.
In general, any treatment for a specific medical condition is reimbursable; cosmetic or preventative expenses are not. For example, teeth-whitening and multi-vitamins are not eligible, but prescription sunglasses and non-prescription allergy medicines are.
Insurance premiums are not eligible for reimbursement.
View a more detailed list of Eligible Expenses.
Expenses incurred during the plan year prior to termination can be submitted for reimbursement for a period specified by the employer in the Plan Document (usually up to 30 days after termination).
Unless your company’s plan document states otherwise, any funds remaining after all eligible reimbursements have been made is forfeit to the cafeteria plan; these funds are used to offset plan losses and expenses.
In order to prevent the loss of funds, it is important to plan carefully so that your annual election matches your actual expenses as closely as possible. Of course, it is impossible to project with 100% accuracy, so you may come up short or have a little money left at the end of the claim period.
However, it is important to realize that loss of funds does not necessarily indicate a loss out-of-pocket. In most cases, even when participants claim less than their election, they still save money by participating in the plan. For example, if your calculated annual tax savings is $1,200 (based on a $4,800 election) and you only use $4,600, you’ve still saved money – in this example, $1,000.
After the claim period, there is a “Run-Out” period as specified in the SPD for submitting claims incurred during the claim period. This allows all eligible expenses up to the very last day of the claim period to be submitted and reimbursed.
An FSA is an account into which your contributions (from pre-tax salary reductions) for medical and/or dependent care expenses are deposited. It functions like a checking account in that the cafeteria plan administrator (myCafeteriaPlan) actually writes you checks for the medical and dependent care expenses that you submit.
The Claim Period is the period specified in the SPD of at least 12 months that determines the beginning and ending dates of expenses eligible for reimbursement, occurring simultaneously with the plan year. In other words, it is the period of time that claims can be incurred and reimbursed from current plan contributions. The beginning date always coincides with the beginning of the plan year, but the end date may not.
For a medical FSA, the maximum annual election is set by your company and can be found in the Summary Plan Description (SPD). For a dependent care FSA, the maximum annual election is set by the IRS and is as follows:
The Plan Year is the 12-month period specified in the SPD that determines the beginning and ending dates of plan contributions (salary reductions).
For medical accounts, the general rule is that if you can claim an individual as a dependent on your tax return, then you can claim them under the Cafeteria Plan.
For dependent care accounts, only children under the age of thirteen or adults or children over the age of thirteen who are incapable of self-care are considered dependents. In addition, the dependent must reside with the participant for the majority of the year in order to be eligible for coverage under the dependent care FSA.
Please note: to be eligible for a Dependent Care FSA, a participant must be employed and, if married, the participant’s spouse must also be employed. A change in employment status for either the participant or the participant’s spouse may result in a change in or loss of eligibility.