A Flexible Spending Account (FSA) is a benefit governed by the IRS and sponsored by your employer. An FSA allows you to pay certain Health Care and/or Dependent Care expenses with pre-tax money. Money is diverted out of each of your paychecks on a pre-tax basis and put into a Health Care Reimbursement Account and/or a Dependent Care Assistance Account.
Health and Dental Insurance Premium Offset: You may have your premium co-payments deducted on a pre-tax basis. This will reduce your gross pay and as such your tax liability.
Dependent Care: This also allows you to have a pre-tax payroll deduction for daycare expenses. Since this is also pre-taxed, it reduces your gross pay and as such, your tax liability.
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- Enrollment Form
Flexilble Enrollment Form to enroll in the Health Care Reimbursement Account, Dependent Care Assistant Account, or elect your health and dental premiums to be deducted pre-tax.
- Direct Deposit Authorization Form
Form used to request that your reimbursements for your Health Care Reimbursement Account or Dependent Care Assistant account be directly deposited to your specified checking or savings account.
- Participant Status/Change Form
If you have a qualifying event during the calendar year; such as marriage/divorce, etc. and need to change your flexible benefit contributions complete this form and send it to HR; Attn: Benefits.
- Reimbursement Request Form
Claim Form to request reimbursement from your Health Care Reimbursement Account or your Dependent Care Assitance Account.
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| CONTACT INFORMATION |
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Benefits Stragegies, LLC
P.O. Box 1300
967 Elm Street
Manchester, NH 03105-1300
Customer Service Phone: (603) 647-4666
(Hours: Mon-Thurs 8:00am - 6:00pm and Fri 8:30am - 5:00pm)
Fax # for claims: (603) 647-4668
Email: claimssupport@benstrat.com
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