What happens to my FSA funds if I terminate or retire, can I receive my remaining balance?

No. However, you can continue to submit claims incurred prior to your termination date before the end of the run-out period (defined in your Summary Plan Description).

For example: Your plan has a 90-day run-out period following termination. Your termination date is September 13th. Your physician sees you on September 12th, but you do not receive the Explanation of Benefits from your insurance carrier until October 31st. You can still submit this expense as it was incurred prior to your termination date, and prior to the end of the 90-day run-out period following your date of termination. Any expense incurred after September 13 is not eligible.

What information is needed for my Dependent Care FSA claim?

Request for Reimbursement Form: Complete the Dependent Care section of the Request for Reimbursement Form and have your daycare provider sign and date.

– Receipt: The receipt must include the following information:

– Name, address and Tax Identification # of provider

– From/through dates of service

– Amount of charge

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