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Flexible Spending Accounts

Introduction

In order to assist you with your out-of-pocket medical and dependent care expenses, Southern Tier Environments for Living offers a Flexible Spending Account (FSA, A.K.A Cafeteria Section 125 Plan) administered by Beneflex. Employee contributions to FSA Accounts are made through a pre-tax, payroll deduction. 

General Information

Third Party Administrator:
Beneflex, Inc.
1030 State Street, Suite 2
Erie, PA 16501
814-453-3107 - Customer Service


FSA Account Types

Medical Care Account.  This account allows you to pay for certain qualified ,out-of-pocket, medical expenses.  The maximum contribution allowed per year is $2,500. See the Summary Plan Descriptions for more details. The medical account allows for a $500 "carry over" from one plan year to another. All remaining funds above $500 in your account at the end of the plan year will be forfeited.

Dependent Care Account.  This account allows you to pay for qualified child care expenses.  The maximum contribution allowed per year is $5,000, or $2,500 for married persons filing separately. Examples of qualified expenses are day care, certain after school programs, and 
certain summer camps. The dependent care account is a “use or lose it” plan. All remaining funds in your account at the end of the plan year will be forfeited. 

Adoption Assistance. This account allows you to pay for adoption expenses on a pre-tax basis. The maximum contribution allowed per year is $12,970. The adoption assistance account is a “use or lose it” plan. All remaining funds in your account at the end of the plan year will be forfeited. 

The FSA is a “use or lose it” plan. All remaining funds in your account at the end of the plan year will be forfeited. 

FSA Calculator

The FSA calculator link below is provided by a third party, use at your own risk. This calculator should give you a good estimate how FSA contributions can save you money by paying for medical/dental/vision, dependent care and adoption costs with "pre-tax" money.


Important Documents & Forms

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F.A.Q. FSA/HRA Debit Card  11k v. 2 Jul 9, 2015, 11:22 AM Wasiewicz, Mark
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2014 FSA Open Enrollment Letter from Beneflex  140k v. 2 Jul 9, 2015, 11:22 AM Wasiewicz, Mark
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FSA Medical Account Eligible Expenses   17k v. 2 Jul 9, 2015, 11:22 AM Wasiewicz, Mark
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FSA Medical Account Expense Worksheet  13k v. 2 Jul 9, 2015, 11:22 AM Wasiewicz, Mark
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FSA Medical Account OTC Expense List  9k v. 2 Jul 9, 2015, 11:22 AM Wasiewicz, Mark
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FSA F.A.Q.'s  70k v. 2 Jul 9, 2015, 11:22 AM Wasiewicz, Mark
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FSA Reimbursement Form  18k v. 2 Jul 9, 2015, 11:02 AM Wasiewicz, Mark
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FSA Enrollment Form  140k v. 2 Jul 9, 2015, 11:21 AM Wasiewicz, Mark
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FSA 2014 Plan Ammendment -IMPORTANT  61k v. 2 Jul 9, 2015, 11:23 AM Wasiewicz, Mark
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FSA Summary Plan Description  65k v. 2 Jul 9, 2015, 11:23 AM Wasiewicz, Mark
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FSA/HRA Online Log-in Instructions  12k v. 2 Jul 9, 2015, 11:23 AM Wasiewicz, Mark