Resources

Helpful Information – Just a Click Away

Welcome to your online resource page. Simply click the link for what you need below.

Forms and Worksheets

Capital Expense Worksheet (PDF) - Helps to determine if your expense is eligible

Dependent Care Tax Credit Worksheet (PDF) - Assists Dependent Care FSA participants in determining the best option between the federal tax credit and a Dependent Care FSA

Mileage Worksheet (PDF) - Helps to track mileage to and from a medical provider

Quick Reference Guides

Appeals Process (PDF) - Learn how the appeals process works regarding denied claims

Submitting Claims (PDF) - Know how to successfully complete an FSAFEDS claim form

Leave Without Pay (LWOP) (PDF) - Understand eligibility regarding a LWOP event

Orthodontia (PDF) - Know how to claim reimbursement for orthodontia expenses

Paperless Reimbursement (PDF) - Find out about the paperless reimbursement process, participating plans and how to enroll

Qualifying Life Events (QLEs) (PDF) - Understand which life events qualify as QLEs under an FSA, how they may affect your FSA election and how to let us know if you experience a QLE

Important Deadlines - View important dates and time frames for FSAFEDS

Supplement Information

The Federal Flexible Benefit Plan (FEDFLEX) - The official plan document that governs FSAFEDS. This is a legal document that conforms to the IRS regulation that state a plan document must be available to participants. This is not a quick reference guide.

IRS Publication 502 (PDF) - Note: While insurance premiums are included in Publication 502, they are NOT reimbursable expenses for FSA purposes.

IRC Section 105 (PDF) - Information regarding Section 105 of the Internal Revenue Code and the treatment of medical expenses.

IRC Section 125 (PDF) - Information regarding Section 125 of the Internal Revenue Code covering cafeteria plans.

IRC Section 129 (PDF) - Information regarding Section 129 of the Internal Revenue Code and the exclusion of dependent care expenses.