Dependent Care Flexible Spending Account

Benefit Consulting Group

Account Reimbursement Schedule 08-09 - Request for Reimbursement Form - Direct Deposit Form - W-10 Form Plan document

Administered by	Benefit Consulting Group PO Box 526 115 1/2 S University Mount Pleasant, MI 48804-0526 989-772-4969 phone 989-772-3539 fax
Description	Pre-tax dollars contributed to your DCSA reimburse you for expenses of certain services, such as the cost of a sitter or day care facility for your eligible children under age 13 and for the costs of similar care for eligible elderly or disabled family members (including your parents and your spouse's parents) who are incapable of self-care and spend at least eight hours per day in your home.
Eligibility	Dependents are determined eligible if considered to be a dependent for federal income tax purposes and are either: a child under the age of 13 or an individual who is physically or mentally incapable of self care.
Eligible Expenses	Must be incurred during the Plan Year. Claims must be submitted within 90 days after the end of the Plan Year. The account covers child care or other dependent day care while you or your spouse work or attend school on a full-time basis. Day care centers must meet all appropriate licensing requirements when providing care for six or more individuals. Expenses qualified for reimbursement include services in or out of your home, including day camps, and must be provided while you attend work. Expenses incurred during periods where you and/or your spouse are not working or attending school full-time (vacations, leaves of absences, holidays, etc.) are not eligible for reimbursement.
Contribution	Minimum $10.00 per pay to a maximum of $5,000/annually. If both you and your spouse have access to a Dependent Day Care Spending Account, the total of the two accounts may not exceed $5,000/annually.
FORFEITURE: IRS REGULATIONS	If you have funds left in the flexible spending account at the end of the plan year, and no eligible expenses to claim, you will forfeit the leftover dollars.
Availability	Once you have paid an eligible DCSA expense, you submit a reimbursement claim form, along with a copy of your paid invoice, to the address on the reimbursement claim form. Your request for reimbursement must include the caregiver's tax ID or Social Security number. You can only withdraw funds that have accumulated in your DCSA account. Box #10 on your W-2 will show the total amount of pre-tax money you put into a Dependent Day Care Spending Account (DCSA).
Direct Deposit	If you participate in a Flexible Spending Account you must establish a direct deposit account for your reimbursements. You will get a quarterly statement.