[Date Prev][Date Next][Thread Prev][Thread Next][Date Index][Thread Index]
Re: Flex Spending Account enrollment and calculation
- To: noelle
- Subject: Re: Flex Spending Account enrollment and calculation
- From: http://dummy.us.eu.org/robert (Robert)
- Date: Mon, 19 Nov 2018 11:04:11 -0800
I decided to lower the amount since the costs are less than I thought and
you won't be doing some of the stuff I will be.
> From: http://dummy.us.eu.org/robert (Robert)
> Date: Sun, 28 Oct 2018 12:12:59 -0700
>
> Anything else that needs to be covered?
>
> -------------------------------------------------------------------------------
>
> Flexible Spending Account
> Deduction Worksheet
> This worksheet will help you calculate your applicable expenses and how
> much money would be in an FSA deduction each pay period.
>
> Medical/Dental/Vision Reimbursement Account
> Annual Medical Expenses, such as:
> Deductibles and co-pays $ _____________
> Routine physical exams $ ___________70
> Prescriptions $ _____________
> Chiropractic care $ _____________
> Gastroenterologist $ _____________
> Podiatrist $ _____________
> Ophthamologist $ __________140
> Audiologist $ ___________70
> Other $ _____________
> Annual Dental Expenses, such as:
> Deductibles and co-pays $ _____________
> Routine check-ups $ __________140
> Orthodontia $ _____________
> Other $ _____________
> Annual Vision Care Expenses, such as:
> Exams $ ___________20
> Eyeglasses $ __________420
> Contact lenses, solutions, cleaners $ _____________
> Other $ _____________
> Slush $ __________500
> Rolled Over from Last Year $ _____________
> Total Estimated $ _________1360
> Medical/Dental/Vision Expenses
> $ _____________ + _________________ = $ __________
> Annual Amount # of Pay Periods* Per Pay Period
> (cannot exceed
> company max.)
>
> *Weekly, 52 pay periods Biweekly, 26 pay periods Semimonthly,
> 24 pay periods Monthly, 12 pay periods
>