Overview & Updates
Flexible Spending Accounts
Flexible spending maximum contribution increase for 2021:
- Health Care Expense Account: $2,750 per year
Employees who enroll in the county-sponsored health insurance for 2021 will receive a county contribution in their Health Care Expense Account as follows:
- Employee-only coverage: $400 one-time contribution
- Family coverage: $500 one-time contribution in 2021 AND $200 in 2022
Health Care Expense funds can be used for: health, dental and vision expenses
The county contribution is not dependent on the election of an employee’s HCEA contribution.
Participant Information
Health Care Expense Account/Dependent Care Assistance Account 2020
pdf
(277.6kB)
Health Care Expense Account/Dependent Care Assistance Account 2021
pdf
(277.1kB)
What is an FSA?
pdf
(142.0kB)
Account Options
pdf
(170.7kB)
Sample List of FSA Eligible Expenses
pdf
(155.7kB)
Tax Savings Example
pdf
(92.6kB)
FSA Store
pdf
(301.0kB)
IRS Publication 969
pdf
(1.4MB)
Parking/Vanpooling Information
pdf
(550.5kB)
Eligible Dependent Defined
pdf
(51.0kB)
Claims & Reimbursements
pdf
(87.6kB)
Submit Claims
pdf
(158.2kB)
Mobile App
pdf
(217.4kB)
FSA Glossary
pdf
(81.4kB)
Not sure how much to contribute to your account? Our FSA calculator can help you figure it out.
Forms
FSA Worksheet
pdf
(54.1kB)
Letter of Medical Necessity Form
pdf
(51.5kB)
HIPAA Authorization Form
pdf
(48.7kB)
FSA Mid-Year Change Form
pdf
(1.3MB)
Parking/Vanpooling Change Form
pdf
(1.9MB)
Parking/Vanpooling Claim Form
pdf
(203.3kB)
Health Care Expense/Dependent Care Assistance Claim Form
pdf
(231.6kB)
Contact Us
Questions?
Chat with a customer service agent now.
Call Us
- Mon-Fri 7:30am - 9:00pm CST
1-833-752-9413
Location
17 Court Street #500
Buffalo, NY 14202 View Map
Buffalo, NY 14202 View Map
Participant Information
Health Care Expense Account/Dependent Care Assistance Account 2020
pdf
(277.6kB)
Health Care Expense Account/Dependent Care Assistance Account 2021
pdf
(277.1kB)
What is an FSA?
pdf
(142.0kB)
Account Options
pdf
(170.7kB)
Sample List of FSA Eligible Expenses
pdf
(155.7kB)
Tax Savings Example
pdf
(92.6kB)
FSA Store
pdf
(301.0kB)
IRS Publication 969
pdf
(1.4MB)
Parking/Vanpooling Information
pdf
(550.5kB)
Eligible Dependent Defined
pdf
(51.0kB)
Claims & Reimbursements
pdf
(87.6kB)
Submit Claims
pdf
(158.2kB)
Mobile App
pdf
(217.4kB)
FSA Glossary
pdf
(81.4kB)
Not sure how much to contribute to your account? Our FSA calculator can help you figure it out.
Forms
FSA Worksheet
pdf
(54.1kB)
Letter of Medical Necessity Form
pdf
(51.5kB)
HIPAA Authorization Form
pdf
(48.7kB)
FSA Mid-Year Change Form
pdf
(1.3MB)
Parking/Vanpooling Change Form
pdf
(1.9MB)
Parking/Vanpooling Claim Form
pdf
(203.3kB)
Health Care Expense/Dependent Care Assistance Claim Form
pdf
(231.6kB)
Contact Us
Questions?
Chat with a customer service agent now.
Call Us
- Mon-Fri 7:30am - 9:00pm CST
1-833-752-9413
Location
17 Court Street #500
Buffalo, NY 14202 View Map
Buffalo, NY 14202 View Map