Limited Use Flexible Spending Account (FSA) Enrollment Form - Monroe County, New York

Limited Use Flexible Spending Account (FSA) Enrollment Form - Monroe County, New York

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.

FAQ

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).

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Form Details:

  • The latest edition currently provided by the Department of Human Resources - Monroe County, New York;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

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.

Download Limited Use Flexible Spending Account (FSA) Enrollment Form - Monroe County, New York

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