Coverage

Employees may set aside money from their paychecks pre-tax for reimbursement for qualified day-care expenses provided for dependents so that the employee (and spouse, if the employee is married) can work.  Care must be for a dependent child under age 13 or a dependent of any age that lives with the employee that is incapable of self-care.   In accordance with Federal law, if you do not use the full amount in your account you will lose the unused balance  at the end of the year. 

Contribution Amount

• Minimum Annual Contribution: $0
• Maximum Annual Contribution:  $5000 per family

Eligible Expenses

• Preschools
• Before and After School Care
• Day Camps

    Full List of Eligible Expenses

Important Information

• Use it or Lose it:   Claim Deadlines Apply.  If funds remain in the account at the end of the claim deadline, they will be forfeited for the plan year sponsor. 
• Open Claims:  Dependent Care Claims may be submitted in advance and will be held as an open claim.  Each time the employee contribution is received it will automatically be processed against the open claim until the entire amount requested as been reimbursed. 
• Contribution Changes:  Contribution amounts may only be changed if you experience a qualified family status change event (i.e. marriage, birth of child, divorce etc.)
• Retirement/Employment Termination:  Per IRS regulations, claims may only be submitted for services prior to the retirement or termination date.
• Separate Accounts:  The medical and dependent care spending accounts may not be co-mingled.
• Household income:  Employees may not draw out more than earned.  If a spouse earns $4000 in a year, $4000 is the maximum draw. 
• Work requirement:  If married, both spouses must be working for dependent care expenses to be covered (some exceptions are made if a spouse is physically or mentally disabled and unable to provide care for dependents). 

Eligibility

• All regular full-time employees, effective the first of the month after 30 days of continuous service
• All regular part-time employees (budgeted for at least 1,000 hours/year), effective the first of the month after 60 days of continuous service

Forms, Links and Vendor Information

FSA Enrollment Form (pdf)

FSA Direct Deposit Form (pdf)

FSA Dependent Care Claim Form (pdf) 

FSA Plan Brochure

Dependent Care Expense Calculator (How much money should you allocate to your FSA?)

Flores and Associates Website  (Claims may now be submitted online.  Log in on the website to access the correct forms).

Plan Administrator

Davidson College

Member Services

Flores and Associates
200 South Tryon Street, Suite 1100
Charlotte, NC  28202

704-335-8211 / 704-335-0818
www.flores247.com

Last Update 10/22/08