General Flexible Spending Guidelines

  • All Flexible Spending plans are regulated and governed by the Internal Revenue Service (IRS).
  • For claims submitted electronically by Tuesday of each week, reimbursements are generally paid by the following Friday.
  • For claims submitted on paper by Friday of each week, reimbursements are generally paid by the following Friday.
  • You must thoroughly complete claim forms, including the patient name, exact service dates, the provider name, and the amount claimed.
  • If you submit your Flexible Spending claim on paper, please remember to sign and date the claim form. Otherwise, your claim won’t be approved.
  • When you receive your reimbursement check, you’ll also receive an explanation of what’s been paid, as well as the amount of your current account balance.
  • You must submit claims for the plan year by March 15 of the following year.
  • Expenses paid by your Flexible Spending account(s) cannot be claimed as income tax deductions.

Medical & Dental Guidelines

  • Beginning January 1, 2011, over-the-counter medications no longer qualify for Flexible Spending reimbursement, unless you have a prescription from your physician. Some over-the-counter items do qualify. Click here to see a list of items that are eligible.
  • Remember, your medical plan premiums cannot be claimed on your income taxes — based on IRS regulations.
  • Include a copy of your Explanation of Benefits — from DMBA or another third-party payer. If you don’t, your claim will be returned.
  • If expenses are for services not covered by your medical or dental plan, include copies of your itemized bills.
  • Balance-due statements are not accepted!
  • For orthodontics, you may submit receipts from the orthodontist showing the payment date, the amount paid, and the name of the patient.
  • You can only be reimbursed for services received during the plan year while you’re contributing to the plan. In the past, you were able to use previous-year funds for FSA-eligible expenses incurred during a January 1 through March 15 grace period, and any unused balance at the end of this grace period was forfeited. That 10-week grace period has been eliminated and replaced by an automatic rollover of up to $500 in unused healthcare FSA funds.
  • Contribution limit: $2,700.00 per year

Dependent Care Guidelines

  • Charges are covered only if:

    • The dependent being cared for is claimed as a dependent on your tax return and:
      • is younger than 13
      • is physically or mentally incapable of self-care and regularly spends at least eight hours a day in your household (this does not mean daily but frequently, on a regular basis)
      • regularly spends at least eight hours a day in your household (this does not mean daily but frequently, on a regular basis
    • You may also claim expenses if you’re a divorced or legally separated taxpayer with custody of a disabled or younger-than-13 child, even if you’ve released the right to a dependency exemption.
    • You must have money deposited in your dependent care account before your claims can be reimbursed.

    • Unlike the healthcare FSA, there is no rollover provision for dependent-care FSA funds remaining at the end of the plan year. You will forfeit any money remaining in your dependent-care FSA at the end of the year.
  • Flexible Spending covers charges for:

    • Baby sitters or companions
    • Day-care centers that meet state and local regulations if they provide care for more than six nonresident people
    • Day-care centers with less than six nonresident people
    • Preschools
    • Persons providing care who are not:
      • claimed as a dependent on your (or your spouse's) tax return
      • your children/stepchildren younger than 19 at the end of the plan year
      • your spouse
    • Expenses for household services that at least partly include the care of a qualifying individual

  • Contribution limits:

    • Single or married filing taxes separately — $2,700.00 per year
    • Married filing taxes jointly — $5,000.00 per year
    • Contributions cannot exceed your earned income or your spouse's earned income, whichever is less.
  • To submit dependent care expenses, both you and your spouse must work, unless your spouse is a full-time student or is disabled. If your spouse is a full-time student or is physically or mentally incapable of self-care, the spouse is deemed to have earned an income of $200 if dependent care expenses apply to one dependent, or $400 if dependent care expenses apply to two or more dependents. These amounts apply for each month of disability or school attendance.

Remember

  • If you choose to participate in Flexible Spending for dependent care expenses, you cannot claim a dependent care credit on your tax return for the portion claimed in Flexible Spending.
  • You cannot use any Flexible Spending money allocated for dependent care expenses for medical expenses, and visa versa. The two accounts must remain separate.
  • You can only be reimbursed for services received during the plan year. Up to $500 remaining in your healthcare FSA at the end of the year will automatically roll over to the new plan year and, after year-end reconciliation, will become available for your use effective April 1 of the new year plan year. Since there is no rollover provision for dependent-care FSA funds, you will forfeit any money remaining in your dependent-care FSA at the end of the year.
  • If you end employment during the plan year, you cannot make additional contributions. Plus, you cannot be reimbursed for expenses incurred after your termination date.
  • You’ll forfeit any balances in your Flexible Spending account at the end of the month in which you end employment or go to part-time status, unless you enroll in COBRA and choose to continue making after-tax Flexible Spending contributions.
  • Attach an invoice for payment to a day-care center or to an individual who provides the care.
  • If an individual provides the care, please include his/her Social Security number or tax identification number.
  • If the provider takes care of more than six children (not including his or her own children), he or she must be licensed by the state.
  • The individual who provides the care cannot be your spouse or your child younger than 19.
  • Expenses claimed cannot exceed your earned income or your spouse's earned income, whichever is less.

Submitting Your Claim:

  • Send paper claim forms and any necessary attachments to:
    DMBA
    Flexible Spending,
    P.O. Box 45530,
    Salt Lake City, UT 84145
  • You may also fax your paper claims to 801-578-5903

Questions