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OR Fax number: 1-252-293-9048 or 1-252-293-9049 Email: shdrflexclaims shdr.com Number of pages in this fax OPTIONS FOR OBTAINING ACCOUNT INFORMATION: website www.shdr.com/flex Flexible Spending Account Reimbursement Claim Form 1-800-930-2441 or 1-800-768-4873 (Monday thru Friday 8:00 a.m. 8:00 p.m. ET) University of New Mexico claims are processed on Tuesday. Claims must be submitted no later than the end of the business day each Friday prior to processing day. Employee Name: Soc.

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Medical Flexible Spending Accounts (FSA) For example, if an employee elects to contribute $1,000 for the year into the FSA, the full $1,000 is available to them on the first day of the plan year. FSAs are notional accounts, meaning no funding is sent to Further.

If you have a health plan through a job, you can use a Flexible Spending Account (FSA) to pay for health care costs, like. deductibles. The amount you pay for covered health care services before your insurance plan starts to pay.

Dependent Care FSA Use the FSAFEDS app to have the dependent care provider certify the service by providing a signature on your mobile device. Have the dependent care provider certify the service by signing the completed claim form (PDF). Submit a claim (PDF) with an itemized statement from the dependent care provider.

Drawbacks of Dependent Care FSA Unfortunately, dependent care FSAs also have pitfalls, such as: Money in your account does not roll over. As a result, you have the current tax year to use FSA dollars for eligible expenses. If money is left over at the end of the year, it doesn't carry over to the next year.

Flexible Spending Account (FSA)

A Flexible Spending Account is an employee benefit that allows you to set aside money from your paycheck, pre-tax, to pay for healthcare and dependent care expenses. Unlike a Health Savings Account (HSA), an FSA is not administered by your health insurance. However, it can still help you save money on income taxes.

With an FSA, you submit a claim to the FSA (through your employer) with proof of the medical expense and a statement that it hasn't been covered by your plan. Then, you'll get reimbursed for your costs. Ask your employer about how to use your specific FSA.

Any Flexible Spending Account lets you make pre-tax payroll contributions to pay for eligible expenses. In other words, FSAs help you unlock significant tax savings and boost your potential spending power. Since the money you contribute and spend is not taxed, you have more money to put toward eligible expenses.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232