b'Healthcare Electionsbenstrat.com/employeesHealthcare FSA Limited-Purpose FSA Dependent Care FSA(Gold Plan enrollees only)What it Eligiblemedical,Eligible dental and vision ex- Eligible dependent care expenses (e.g. day-prescription,drug,dental,penses.Note:IRSrulespre- carecentersandeldercarecenters)for Pays For andvisionexpenses that arevent employees who open anchildrenunderage13,disabledchildren, not covered by yourHSA from participating in thedisabled parents, a disabled spouse or other healthcare plans, includingHealthcare FSA. relatives who qualify under the IRS code, so deductiblesandcopays,that you and/or your spouse can work eyeglasses and contactoutside the home or attend school.lenses, and hearing aids. Note: All employees (regardless of medical plan choice)canparticipateinthe Dependent Care FSA.How it Use your FSA debit card to pay for eligible expenses at your localSubmit a claim form for reimbursement after pharmacy or doctors office. When you use your FSA debit card,services have been received and paid. In Works eligible expenses are deducted directly from your FSA, so theresorder for your Dependent Care FSA con-no need to file a claim; however, always save your receipts in casetributions to be considered eligible for reim-you do need to verify an expense. If you dont use your FSA debitbursement, your provider must claim your card, youll need to pay for services using another method, and thenpayments as taxable income. Because the submit a claim form for reimbursement. tax rules are complex and are based on cal-endar year expenses, you may want to con-sult a tax advisor for assistance11'