Plan Information for Dependent Care FSA benefits
| Overview |
The Dependent Care FSA lets you pay for qualified out-of-pocket, work-related, day-care expenses for a child or elder dependent who you can claim on your Federal Income Taxes.
Children must be under age 13. Other dependents must be physically or mentally unable to care for themselves. Eligible expenses include daycare/eldercare, preschool, summer day camps,
or before/after school care. The Flexible Spending Accounts are managed by ASIFlex.
Note: The Dependent Care FSA does NOT reimburse medical, dental, or vision expenses for your dependents; it is only used for eligible day care expenses.
The IRS allows no more than $5,000 per household ($2,500 if you are married and file a separate tax return) be set-aside in the Dependent Care Flexible Spending Account in a calendar year.
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| Who is Eligible? |
Dependent Care Flexible Spending Account benefits are available to all State of New Hampshire employees who work a minimum of 30 hours per week. Newly hired employees have a 45 day window in which to apply for this benefit. |
| How to Enroll |
Elect to participate within 45 days of being newly hired; during the annual
Open Enrollment period; or within 30 days of a qualifying life event (such
as gaining new dependents due to marriage, new enrollment in daycare, etc.), by completing a
FSA Enrollment/Change Form
and submitting it to your agency benefit representative within the specified
time period.
Important Note: FSA enrollments do not auto-renew and a
new election must be made EVERY year during Open Enrollment.
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| How it Works |
- Determine the amount of unreimbursed eligible dependent childcare/elder-care expenses you - and where applicable, your eligible family members - will likely incur during the plan year. Keep in mind the IRS limit for pre-tax contributions to your Dependent Care FSA is $5,000 per household.
- Elect to have the State of New Hampshire withhold an annual amount which will be withheld in equal amounts from your pay on a pre-tax basis for reimbursement of these expenses. Elect wisely as you forfeit any dollars remaining in a flexible spending account that you do not use for expenses incurred during the plan year. Funds are available in your ASIFlex account the day after your paycheck in which a deduction is taken.
- Submit your dependent childcare/elder-care claims for reimbursement.
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| How to Submit Claims? |
You have three options for submitting your Dependent Care FSA claims for reimbursement:
- Submit your claim online through ASIFlex, State of New Hampshire's FSA administrator.
- Submit claims using ASIFlex's free mobile app.
- Complete a Flexible Spending Account (FSA) Claim Form and submit a receipt for each expense incurred. Fax or mail your completed claim form to:
FAX: 1-877-879-9038
Mail To:
ASIFlex
PO Box 6044
Colombia, MO 65205-6044
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| Summary Plan Description (SPD) |
Flexible Spending Summary Plan Description |