Flexible Spending Accounts

²ÝÁñ³ÉÈËÉçÇø provides full-time and part-time staff members who are scheduled to work at least the equivalent of 26 hours per week (52 weeks per year, or 1,352 hours annually) the opportunity to contribute to flexible spending accounts (FSA). Employees must also meet the specified waiting period for each type of account. Please refer to the Benefits Guidebook, Handbooks and Policies and other provided plan documentation for complete details. You may also contact Human Resources with any questions.

*** Please note that while a "paper" claim form is available, it is recommended you submit claims directly through the ***

Medical Care FSA

A Medical Care Flexible Spending Account (FSA), administered by Inspira, provides you with the ability to save money on a pre-tax basis to pay for any IRS-allowed medical, Rx, dental or vision expense that is not covered by your health care plan. Examples of these types of expenses include:

  • Deductibles and copayments
  • Expenses for medical services or supplies not covered by your plan
  • Dental, vision and hearing care expenses
  • Transportation expenses related to medical care
  • Nursing care

Your annual contribution is divided by your number of pay periods and that amount will be deducted pre-tax each pay period. The amount you elect may not be changed or revoked during the plan year unless you experience a qualifying life event. Also, you may not transfer funds between a Medical Care FSA and a Dependent Care FSA.

For the 2025 Plan Year, the maximum amount that you may contribute to a Medical Care FSA is $3,300.

Dependent Care FSA

A Dependent Care Flexible Spending Account (FSA), administered by Inspira, provides you with the ability to set aside money on a pre-tax basis for day care expenses for your child, disabled parent or spouse. Generally, expenses will qualify for reimbursement if they are the result of care for:

  • Your children, under the age of 13, for whom you are entitled to a personal exemption on your federal income tax return.
  • Your spouse or other dependent, including parents, who are physically or mentally incapable of self-care.

For the 2025 Plan Year, the maximum amount that you may contribute to a Dependent Care FSA is $5,000. The IRS has set the maximum allowable contribution per calendar year for a Dependent Care Flexible Spending Account as follows:

  • $5,000 for a married couple filing jointly
  • $5,000 for a single parent
  • $2,500 for a married person filing separately

Use It or Lose It

Unused balances at the end of the plan year will be forfeited.

Plan Information

Forms

Contact Information

  • Online:
  • Phone: 844-729-3539