Limited Use Flexible Spending Account (FSA) Enrollment Form is a legal document that was released by the Department of Human Resources - Monroe County, New York - a government authority operating within New York. The form may be used strictly within Monroe County.
Q: What is a Limited Use Flexible Spending Account (FSA)?
A: A Limited Use Flexible Spending Account (FSA) is a type of flexible spending account that can only be used for specific expenses, such as dental and vision care.
Q: Who is eligible to enroll in a Limited Use Flexible Spending Account (FSA)?
A: Employees of Monroe County, New York who meet the eligibility requirements.
Q: What expenses can be paid for with a Limited Use Flexible Spending Account (FSA)?
A: Expenses related to dental and vision care, such as dental exams, glasses, contact lenses, and orthodontics.
Q: How does a Limited Use Flexible Spending Account (FSA) work?
A: Employees contribute a portion of their salary to the account on a pre-tax basis, and then use the funds to pay for eligible expenses.
Q: Are contributions to a Limited Use Flexible Spending Account (FSA) tax-deductible?
A: No, contributions to a Limited Use Flexible Spending Account (FSA) are made on a pre-tax basis, so they are not tax-deductible.
Q: What happens to unused funds in a Limited Use Flexible Spending Account (FSA)?
A: Unused funds in a Limited Use Flexible Spending Account (FSA) may be forfeited at the end of the plan year, depending on the specific rules of the plan.
Q: Can I change my contribution amount to a Limited Use Flexible Spending Account (FSA)?
A: Changes to contribution amounts may only be made during the annual open enrollment period, or in the event of a qualifying life event.
Q: How do I enroll in a Limited Use Flexible Spending Account (FSA)?
A: Employees need to complete the enrollment form provided by Monroe County, New York.
Q: Can I use a Limited Use Flexible Spending Account (FSA) for over-the-counter medications?
A: No, over-the-counter medications are generally not eligible for reimbursement from a Limited Use Flexible Spending Account (FSA), unless prescribed by a doctor.
Q: What are the deadlines for submitting claims for a Limited Use Flexible Spending Account (FSA)?
A: Employees should refer to the specific plan rules for deadlines on submitting claims for reimbursement from a Limited Use Flexible Spending Account (FSA).
Form Details:
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Department of Human Resources - Monroe County, New York.