Flexible Spending Accounts (FSAs)

If you choose to participate, the Flexible Spending Accounts (FSAs) let you pay eligible expenses with dollars that are never taxed. Your contributions to the FSA are deducted from your pay before federal income and Social Security taxes are withheld—and, in many states, before state and local income taxes are withheld. When you receive reimbursement from your FSA, the amount you receive is not subject to tax. The result is that you pay less in taxes and the savings reduce the net cost of these expenses. You can save 10–35% on everyday purchases, like childcare and your vision and dental plan deductibles. For example, if you have a tax rate of 25% and you’re enrolled in an Aetna Dental Plan, your $50 dental deductible effectively costs you only $37.50. (NOTE: Puerto Rico team members are not eligible to participate in the Limited-Purpose Health Care and/or Dependent Care FSA.)

The Limited-Purpose Health Care FSA works hand-in-hand with the HSA, but is used for qualified dental and vision expenses only. This replaces our old health care FSA because all qualified medical and prescription drug expenses must be paid through your HSA or out of pocket, in order to satisfy IRS rules and allow an HSA account.

Eligible dental and vision expenses for a Limited-Purpose Health Care FSA include deductibles and copayments, your share of covered expenses, dental and orthodontia expenses, prescription glasses, contact lenses, lens cleaning solution and laser vision correction.

The Limited-Purpose Health Care FSA is administered by PayFlex and offers a benefits card; it’s like a check card you can use to pay for eligible expenses at the point of service.

If you anticipate having unreimbursed medical and/or prescription drug expenses, deposit money tax-free in your HSA.

The Limited-Purpose Health Care FSA is the only Health Care FSA offered starting July 2014.

Yes. You must re-enroll during Annual Enrollment if you want to participate in the Limited-Purpose Health Care and Dependent Care Flexible Spending Accounts. (NOTE: Puerto Rico team members are not eligible to participate in the Limited-Purpose Health Care and/or Dependent Care FSA.)

 

You can contribute from $100 to $2,500 to a Limited-Purpose Health Care Flexible Spending Account and $100 to $5,000* a year to your Dependent Care Flexible Spending Account. If you are married and file a separate tax return, you can contribute from $100 to $2,500* to your Dependent Care Flexible Spending Account.  

Your contribution amount will be deducted from each paycheck on a pre-tax basis in equal installments throughout the plan year.  (NOTE: Puerto Rico team members are not eligible to participate in the Limited-Purpose Health Care and/or Dependent Care FSA.)

* If you are considered a highly paid team member, you can contribute a maximum of $1,200 each year. Maximums may be lowered at and/or after enrollment to satisfy nondiscrimination requirements.

No. You cannot decrease, increase or suspend your contributions during the plan year unless you have a qualifying life event. Any change you make to your contribution level must be consistent with the life event.

No. You cannot transfer money from one account to another, so be sure to estimate your annual expenses carefully before you make your contribution elections.

The Company offers Consumer Directed Health Plans (CDHPs) and encourages the use of Health Savings Accounts (HSAs). If you are participating in an HSA, IRS rules prohibit contributions to a Health Care Flexible Spending Account. However, you may enroll in a Limited-Purpose Health Care Flexible Spending Account for reimbursement of eligible dental and vision expenses.

You cannot be reimbursed for any expenses that are paid for by any health plan that covers you or your eligible dependents. The FSA SPD includes a list of many eligible expenses. The IRS provides a complete list of eligible health care–related expenses. Download IRS Publication 502 or call 1-800-829-3676 to request a free copy.

Eligible dependent care expenses must be necessary to allow you to work (if you are married, your spouse must also work, be enrolled as a full-time student at an educational institution or be mentally or physically incapacitated). Expenses that can be reimbursed from your Dependent Care Flexible Spending Account include services provided:

  • Inside or outside of your home by anyone other than your spouse, the child’s parent, a person you list as your dependent for income tax purposes or one of your children under the age of 19.
  • In a dependent care center or a child care center (if the center provides day care services for more than six people, it must comply with all state and local laws).
  • By a housekeeper whose services include providing care for an eligible dependent.
  • Through child or adult day care, nursery school, pre-school, after school or summer day camp programs (taxes you pay on wages for eligible dependent care can also be reimbursed).

The FSA SPD includes a list of many eligible expenses. The IRS provides a complete list of eligible dependent care–related expenses. Download IRS Publication 503 or call 1-800-829-3676 to request a free copy. You may also want to consult with your tax advisor for additional information.

Getting reimbursed for eligible claims incurred during the 2015–2016 plan year, which runs from July 1, 2015, through June 30 2016, through PayFlex is easy.

You have three options:

  1. Use your debit card (for dental and vision expenses)—When you incur an eligible dental or vision expense, you simply swipe your debit card at the point of sale and run as credit. The amount of the purchase is deducted directly from your Limited-Purpose Health Care FSA account balance and paid to your health care provider. It is important to save all receipts, as you will be required to submit receipts for debit card transactions to substantiate the expenses.
  2. File claims via fax at 402-231-4310 or by mail to PayFlex Systems USA, Inc., Flex. Dept., P.O. Box 3039, Omaha, NE 68103-3039. Overnight address is 10802 Farnam Drive, Suite 100, Omaha, NE 68154.
  3. Download an FSA reimbursement form.
  • Complete the form and include appropriate documentation for:
    • Dental and vision expenses—you can submit either an Explanation of Benefits (EOB) from your insurance company or an itemized bill containing the: 1) date of the service, 2) amount of the charge for the service, 3) provider name, and 4) type of service performed.
    • Orthodontia expenses—you can submit an itemized statement/paid receipt, the orthodontist’s contract/payment agreement, or monthly payment coupons. Learn more about your reimbursement options.
    • Dependent day care expenses—you can either have your provider complete the claim form or include your receipt from the provider, which must include: 1) provider Social Security number or Tax ID number, 2) date(s) of service, and 3) amount paid.
  • Fax the form along with your documentation to Payflex at 402-231-4310, or mail the form to: 
    PayFlex FSA Services, Flex. Dept., P.O. Box 3039, Omaha, NE 68103-3039. Overnight address is 10802 Farnam Drive, Suite 100, Omaha, NE 68154.

You have until September 30th following the end of the current plan year to submit claims for reimbursement to PayFlex for expenses incurred in the previous plan year. For example, expenses you incurred between July 1, 2015, and June 30, 2016, can be submitted up until September 30, 2016. Be sure to file claims promptly since you will forfeit any balance remaining in your account after September 30.

Claims after you leave the Company, no longer participate, or become ineligible for the Flexible Spending Account (FSA).
If you leave Toys"R"Us, Inc., no longer participate in the FSA or become ineligible for the FSA, all eligible expenses incurred through the date your employment ends, the date you no longer participate or the date you are no longer eligible, must be submitted by September 30 following the end of the current plan year. For the Health Care or Limited-Purpose FSA, you can be reimbursed only up to the total amount you elected to contribute, minus amounts already paid to you. For the Dependent Care FSA, you can be reimbursed only up to the total amount you actually contributed, minus amounts already paid to you.  Any unused balance remaining in your Limited-Purpose Health Care and/or Dependent Care FSA account(s) after all claims have been submitted will be forfeited.

Yes. IRS rules state that money you contribute pre-tax to these accounts must be used to reimburse eligible expenses for the plan year. You have until September 30th, following the end of the current plan year, to submit claims for reimbursement and use the balance in your account for the previous plan year. If you leave Toys"R"Us, Inc., no longer participate in the FSA or become ineligible for the FSA, all eligible expenses incurred through the date your employment ends, the date you no longer participate or the date you are no longer eligible, must be submitted by September 30th following the end of the current plan year. If you don’t use the entire balance, you will forfeit it, so be sure to estimate your annual health care and dependent care expenses carefully before you make your contribution elections.

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