Minimum Annual Deposit: $10 per pay period ($260 per year)

Maximum Annual Deposit: (including a $50.96 annual administrative fee)

The maximum contribution depends on your tax filing status as the list below indicates.

Partial List of Eligible Expenses*

    After school care

    Baby-sitting fees

    Day care services

    In-home care/au pair services

    Nursery and preschool

    Summer day camps

Note: Budget conservatively. No reimbursement or refund of Dependent Care FSA funds is available for services that do not occur within your plan year.

* IRS-qualifi ed expenses are subject to federal regulatory change at any time during a tax year.Certain other substantiation requirements and restrictions may apply, and will be supplied to you following enrollment.

What is a Dependent Care FSA?

A Dependent Care FSA is an IRS tax-favored account you can use to pay for your eligible dependent care expenses to ensure your dependents (child or elder) are taken care of while you and your spouse (if married) are working. These funds are set aside from your salary before taxes are deducted, allowing you to pay your eligible expenses tax free. A partial list of these eligible expenses can be found on this page.

Whose expenses are eligible?

You may use your Dependent Care FSA to receive reimbursement for eligible dependent care expenses for qualifying individuals.

A qualifying individual includes a qualifying child, if they:

• are a U.S. citizen, national or a resident of the U.S., Mexico or Canada
• have a specified family-type relationship to you
• live in your household for more than half of the taxable year
• are 12 years old or younger and
• have not provided more than one-half of their own support during the taxable year.

A qualifying individual includes your spouse, if they:

• are physically and/or mentally incapable of self care
• live in your household for more than half of the taxable year and
• spend at least eight hours per day in your home.

A qualifying individual includes your qualifying relative, if they:

• are a U.S. citizen, national or a resident of the U.S., Mexico or Canada
• are physically and/or mentally incapable of self care
• are not someone else's qualifying child
• live in your household for more than half of the taxable year and
• spend at least eight hours per day in your home
• receive more than one-half of their support from you during the taxable year.

Note: If you are the tax dependent of another person, you cannot claim qualifying individuals for yourself. You cannot claim a qualifying individual if they file a joint tax return with their spouse. Only the custodial parent of divorced or legally-separated parents can be reimbursed using the Dependent Care FSA.

What is my maximum annual deposit?

• If you are married and filing separately, your maximum annual deposit is $2,500.
• If you are single and head of household, your maximum annual deposit is $5,000.
• If you are married and filing jointly, your maximum annual deposit is $5,000.
• If either you or your spouse earn less than $5,000 a year, your maximum annual deposit is equal to the lower of the two incomes.
• If your spouse is a full-time student or incapable of self-care, your maximum annual deposit is $3,000 a year for one dependent and $5,000 a year for two or more dependents.

When are my funds available?

Once you sign up for a Dependent Care FSA and decide how much to contribute, the funds available to you depend on the actual funds in your account. Unlike a Healthcare FSA, the entire maximum annual amount is not available during the plan year, but rather after your payroll deductions are received.

Should I claim tax credits or exclusions?

Since money set aside in your Dependent Care FSA is always tax free, you guarantee savings by paying for your eligible expenses through your IRS tax-favored account. Depending on the amount of income taxes you are required to pay, participation in a Dependent Care FSA may produce a greater tax benefit than claiming tax credits or exclusions alone.

Remember, you cannot use the dependent care tax credit if you are married and filing separately. Further, any dependent care expenses reimbursed through your Dependent Care FSA cannot be filed for the dependent care tax credit, and vice versa.

To help you choose between the available taxable and tax-free benefits, or a combination of both, consult your tax advisor and/or the IRS for additional information. You may also visit www.fbmc-benefits.com to complete a Tax Savings Analysis.

Are some expenses ineligible?

Expenses not eligible for reimbursement through your Dependent Care FSA include: 

Will I need to keep any additional documentation?

To claim the income exclusion for dependent care expenses on IRS Form 2441 (Child and Dependent Care Expenses), you must be able to identify your dependent care provider. If your dependent care is provided by an individual, you will need their Social Security number for identification, unless he or she is a resident or non-resident alien who does not have a Social Security number. If your dependent care is provided by an establishment, you will need its Taxpayer Identification number.

If you are unable to obtain a dependent care provider’s information, you must compose a written statement that explains the circumstances and states that you made a serious and earnest effort to get the information. This statement must accompany your IRS Form 2441.

When do I request reimbursement?

You can request reimbursement from your Dependent Care FSA as often as you like. However, your approved expense will not be reimbursed until the last date of service for which you are requesting reimbursement has passed. Also, remember that for timely processing of your reimbursement, your payroll contributions must be current.

How do I request reimbursement?

Requesting reimbursement from your Dependent Care FSA is easy. Simply mail or fax a correctly completed FSA Reimbursement Request Form along with receipts showing the following:

• the name, age and grade of the dependent receiving the service
• the cost of the service
• the name and address of the provider and
• the beginning and ending dates of the service.

Be certain you obtain and submit the above information when requesting reimbursement from your Dependent Care FSA. This information is required with each request for reimbursement.

Mail to: Contract Administrator

Fringe Benefits Management Company

P.O. Box 1800

Tallahassee, FL 32302-1800

Fax to: 850-425-4608

Note: If you elect to participate in the Dependent Care FSA, or if you file for the Dependent Care Tax Credit, you must attach IRS Form 2441, reflecting the information above, to your 1040 income tax return. Failure to do this may result in the IRS denying your pre-tax exclusion.