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Dependent care fsa Form: What You Should Know

FSA Claim Form — Dependent Care FSA Claim Form- Dependent Care Provider Mail the completed FSA Claim Form, along with a copy of the provider's itemized bill, or other required documents showing the payments, to the Provider's address below. Dependent Care Payment (for children and eligible dependents) Dependent Care Payment (for children and eligible dependents) Covered California Children must have dependents (child) for whom they received dependent care coverage through their FSA (dependent care reimbursement). When you file your claim, it is also important to include proof that the child is a dependent. You can present any one of the following if you are a covered California family: Certified copy of child's birth certificate Proof that the dependent has been approved for a health plan Proof the child has a health insurance ID Proof the child (such as a parent or legal guardian) has health insurance Note: If the dependent's (child) health insurance ID has recently changed (from a previous year's ID's), you will need to notify the DFS program to make your claim. If you did not make the required medical and/or dependent care claims, you must file an administrative appeal with the DFS program. The DFS must be satisfied that you are qualified for the benefits you were denied. Please visit Health Coverage for Dependents, to learn how you can submit and/or process your administrative appeal. You Can Get Help If...

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Instructions and Help about Dependent care fsa

A dependent care reimbursement account is a tax-advantaged account. It allows you to set aside a portion of your earnings to pay for qualified dependent care expenses with pre-tax money. Payroll deductions deposited to your account occur on a pre-tax basis, decreasing your taxable income. You can use the funds in your account to pay for certain expenses to care for dependents that live with you while you're at work. This includes dependent children up to age 13, as well as senior citizen dependents that live with you, such as parents. Unlike health care flexible spending accounts, dependent care flexible spending accounts cannot be pre-funded. You can only receive reimbursements as funds are deposited into the account. Generally, you pay for expenses as they occur and submit for reimbursement from the administrator. Reimbursements may come in the form of a check or direct deposit, depending on how your account is set up. It's important to know that if you're married, both spouses must earn income in order to participate in the dependent care FSA. The only exception is if the non-earning spouse is disabled or a student. There are annual contribution limits that determine the minimum and maximum you can contribute to the dependent care account. You also need to re-enroll each year you wish to participate. Funds remaining in your account at the end of the plan year and any grace period are forfeited. This is known as the use-it-or-lose-it clause, so it's usually a good idea to plan your contributions so you don't have any funds remaining in your account. Your dependent care reimbursement account provides an important benefit to help you save for dependent care expenses. There are additional requirements you need to be aware of, so be sure to review your plan document in detail.