DOCUMENTS & FORMS

Navia Benefit Solutions

Flexible Spending Account (FSA)

The Flexible Spending Account (FSA) allows you to make pre-tax deductions from payroll and then use those pre-tax funds to pay for eligible expenses.

There are three different plans: 

• The Health Care FSA Plan is used for eligible out-of-pocket healthcare costs.
• The Limited Purpose Health Care FSA Plan works the same as the health care FSA, however you are limited to reimbursement for dental and vision expenses only. You can only enroll in this plan if you are enrolled in the xxx HDHP HSA.
• The Dependent Day Care FSA Plan is used for eligible dependent care expenses for children under the age of 13 or dependent adults.  You and your spouse must both work or be a full-time student in order to participate.

You can choose to contribute to one or both Health Care (either Full Purpose or Limited Purpose) and Dependent Care Plans. Here’s how the plans work:

1. You determine how much to contribute.
2. Your contributions are then taken out of your pay in equal amounts each pay period before taxes are deducted.
3. You and your tax-qualified dependents incur eligible expenses.
4. You use your FSA Debit Card to pay for healthcare and/or dependent care expenses at participating locations, or file a claim online, via fax or mail for reimbursement.
5. Your reimbursements are paid to you tax-free.

Navia Benefit Solutions

• www.naviabenefits.com
• 1-800-669-3539