
Flexible Spending Accounts (FSA)
Flexible Spending Accounts (FSAs) from Optum Bank let you set aside pre-tax dollars for eligible health and dependent care expenses. You can enroll in one or both FSAs and must choose your annual contribution amount, which is deducted pre-tax from your paycheck.

Health Care FSA
IRS Annual Maximum: $3,300
- Covers eligible expenses for you, your spouse/domestic partner, and children.
- Use the full annual amount anytime during the plan year.
- Eligible expenses include copays, coinsurance, deductibles, orthodontia, and glasses/contacts. For a complete list, refer to IRS Publication 502: Medical and Dental Expenses, available at www.irs.gov/publications.
- When you incur an eligible expense, you can use your Optum Bank debit card or pay out-of-pocket and submit a reimbursement request with documentation.
- Not available if enrolled in HDHP with HSA.

Limited Purpose FSA
IRS Annual Maximum: $3,300
- For HDHP with HSA participants.
- Covers eligible dental and vision expenses only.
- The Limited Purpose FSA also allows for reimbursement of medical expenses subject to meeting the Cigna HDHP/HSA plan's annual deductible

Dependent Care FSA
IRS Annual Maximum: $5,000
- Covers daycare expenses for children 12 and under, or older dependents who cannot physically or mentally care for themselves.
- Care must be necessary for you and your spouse to work.
- Care may be provided through live-in care, babysitters, or licensed daycare centers.
- Reimbursement only up to the amount available in your account after payroll contributions.
Learn more:
- Plan documentation
Important:
FSAs offer tax advantages, but are subject to IRS regulations.
Deadlines
All expenses for the Health Care and Dependent Care Flexible Spending Accounts must be incurred during the plan year: January 1 through December 31. Must file claims by March 31 of following year.
Contact
Optum Bank 877-620-6194 www.optumbank.com