4. How do I file a claim?
After the participant has paid for an eligible expense, they must submit a claim for reimbursement. Individuals must download our DCAP/FSA Claim Form (PDF) and submit the completed form along with receipts or other required documentation to eBenefits Administrators, Inc. You may also get a copy of the form from your Human Resources department.
When submitting a DCAP claim, a bill or receipt from the care provider is required. The receipt must include:
- Provider name, address, and Tax ID number
- Date(s) of service for the daycare
- Dependent name(s)
- Description of service (daycare)
- Cost
Services must be rendered during the plan year and must be incurred prior to reimbursement. Employees may
submit one claim form at the beginning of the plan year, and they will be reimbursed according to their
care providerÕs pay schedule.
When the claim is approved, you will be reimbursed the full amount of your eligible expenses. Claims are processed on a weekly basis., and all claim submissions must be received by eBenefits Administrators by 5:00 PM three business days prior to the scheduled processing day to be included in that weekÕs reimbursement run. All claims received after the claim submission deadline will be held over until the next processing day.
5. Which expenses are eligible?
Below is a quick reference list of eligible expenses according to the Internal Revenue Code and Federal court. Expenses claimed under a DCAP may not be applied toward the dependent care tax credit on an participantÕs income tax return. In most cases, the DCAP tax deduction is greater than the dependent care tax credit.
- After-school care
- Adult day care facilities
- Adult in-home day care
- Care provided at a day-care center or other location
outside your home
- Housekeeping services provided at least in part
for the dependent
- In-home dependent care
- Private preschool program
- Public or private before-school/after-school care
- Summer day camp (if cost is reasonable
compared to other alternatives and the main
purpose is to provide for the childÕs well-being)
Dependent care expenses must also meet the statutory requirements of IRC sections 21 and 129. For more information, refer to IRS Publication 503 or consult your tax adviser.
6. What happens to funds I don't use?
Under IRS regulations, any monies not claimed from a DCAP are forfeited back to the employer and are used to offset the administrative costs of the plan.
7. What if I separate from employment?
If you separate your employment, you may submit claims only for eligible expenses incurred through the last day of employment. Expenses incurred after this date are not eligible for reimbursement.
8. Who do I contact if I have additional questions?
eBenefits Administrators, Inc.
PO Box 3269
Erie, PA 16508-0269
814.866.9400 or 800.494.6804
admin@ebeneadmin.com
1. How does an FSA work?
After you enroll, the FSA works like this:
- The amount you have specified is taken from your paycheck each month and deposited in your health care account
- You pay your health care expenses as usual (unless a debit or credit card is used)
- You submit a claim form and receipts to eBenefits Administrators, Inc. requesting reimbursement for these expenses
- Your claim is processed for reimbursement and the funds are forwarded to you via direct deposit or paper check. If a debit or credit card is used, eligible expenses are deducted from your available credit in your FSA.
2. Must I enroll every year to continue participation in an FSA?
Yes, you must submit a completed enrollment form to your Human Resources department in order to continue participation in an FSA. Your previous FSA election will NOT carry over to the next year.
3. How much can I contribute to my FSA?
The maximum annual contribution differs for each employer. Please see your Plan Administrator for your maximum contribution amount.
4. Can I change the contribution amount at a later date?
Yes, IRS regulations state that an individual may change or stop his or her FSA contributions only within 31 days from the date of a qualified change in family status, such as marriage, birth/adoption of a child, divorce, death, or if you or your spouse change employment status.
Any change must be consistent with the reason the change was permitted. For example, a marriage or birth would allow you to increase your FSA election whereas a divorce would allow you to reduce your FSA election.
5. When may I enroll in an FSA?
Employees must enroll in the FSA during the open enrollment period at each FSA Plan Year renewal, or you may enter the plan mid-year after you have satisfied your employer's probationary/waiting period. Please keep in mind that if you do not elect to participate during your open enrollment period, you must wait for the following year's open enrollment period to enter the Plan unless you have a valid change of family status as noted above.
You must complete an enrollment form and submit the completed enrollment form to your Human Resources in order to participate in the plan.
6. How do I file a claim?
After the participant has paid for an eligible expense, they must submit a claim for reimbursement. Individuals must download our DCAP/FSA Claim Form (PDF) and submit the completed form along with receipts or other required documentation to eBenefits Administrators, Inc. You may also get a copy of the form from your Human Resources department.
A receipt for any type of medical, prescription, dental or vision service must include:
- Date
- Patient name
- Placeof service
- Description of service
- Cost or copayment
Note: As of January 1, 2011, FSA funds can no longer be used to purchase over-the-counter medicines and drugs unless the medicine or drug is prescribed. A receipt for any type of over-the-counter item must include:
- Date
- Description of service
- Cost
When the claim is approved, you will be reimbursed the full amount of your eligible expenses. Claims are processed on a weekly basis., and all claim submissions must be received by eBenefits Administrators by 5:00 PM three business days prior to the scheduled processing day to be included in that weekÕs reimbursement run. All claims received after the claim submission deadline will be held over until the next processing day.
7. Which expenses are eligible?
Please click here to download a list of eligible/ineligible expenses in PDF format.
8. What happens to funds I don't use?
Under IRS regulations, any monies not claimed from an FSA are forfeited back to the employer and are used to offset the administrative costs of the plan.
9. What if I separate from employment?
If you separate your employment, you may submit claims only for eligible expenses incurred through the last day of employment.
10. Can you have an FSA combined with a Health Savings Account (HSA)?
A general-purpose FSA would prevent an individual from being eligible for HSA contributions. However, limited-purpose FSAs do not prevent HSA eligibility. A limited-
purpose FSA may only permit coverage for vision, dental and preventive care and must be specifically spelled out in the Section 125 Cafeteria Plan document. The
limited-purpose FSA can be very beneficial to participants. Just as with a general-purpose FSA, 100% of the election will be available at the start of the plan year.
11. Who do I contact if I have additional questions?
eBenefits Administrators, Inc.
PO Box 3269
Erie, PA 16508-0269
814.866.9400 or 800.494.6804
admin@ebeneadmin.com
