Medical FSA Brochure

Dependent Care FSA Brochure

FSA Flex Spending Enrollment Form (Medical and Dependent Care)

The Health Care Flexible Spending Account (FSA) can reimburse you for eligible expenses you or your eligible dependents incur that are not paid by your existing health care plan. You can set aside pre-tax money into an account to be reimbursed for eligible medical expenses. Savings will depend on your tax bracket. For example, if you are taxed at 25% and you enroll for $3,050 you would save $762.50 in taxes.

ELIGIBLE EXPENSES: Medical co-payments, co-insurance and deductibles • Routine wellness visits • Prescription expenses • Vision expenses (including eye exams, eyeglasses and contact lenses) • LASIK surgery • Dental expenses (excluding cosmetic procedures) • Orthodontia payments • Hearing expenses • Over-the-counter Medications • Menstrual Care Items • COVID-19 Related PPE
for full list of eligible and ineligible expenses, please visit the IRS website: www.irs.gov
MAXIMUM CONTRIBUTION: An employee who chooses to participate in an FSA can contribute up to $3,200 through payroll deductions during the 2024 plan year.
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The Dependent Care Flexible Spending Account (DFSA) can reimburse you for day care expenses provided for your dependents to that you (an your spouse, if you are married) can work. Care much be for a dependent child under age 13 or a dependent of any age that lives your household that is incapable of self-care. You can set aside pre-tax money into an account to be reimbursed for eligible dependent childcare expenses. Savings will depend on your tax bracket. For example, if you are taxed at 25% and you enroll for $5,000 you would save $1,250 in taxes.

ELIGIBLE EXPENSES: Preschools • Before and after school care • Day camps
INELIGIBLE EXPENSES: Overnight camps • Tuition / kindergarten & educational expenses • Regular fees not applied to care of child
MAXIMUM CONTRIBUTION: The Dependent Care FSA (DCFSA) maximum annual contribution limit did not change for 2024. It remains at $5,000 per household or $2,500 if married, filing separately.

South Portland School Department

Behavioral Health Resources: Aspire 365 - For Employees/Families Enrolled in Anthem Healthcare

2024-2025 Rate Information

Anthem Plan Information

Anthem: Additional Important Health Plan Documents and Required Notices

Delta Dental Information

MSMA Dental Information

FSA - Flexible Spending Accounts (Medical and/or Dependent Care)

Enrollment Forms

Pay Election Forms

Address Changes

In Lieu Of Healthcare Payment