Flexible Spending Accounts

You can be reimbursed up to the annual amount you have elected to contribute to this account, even if it exceeds the amount currently in your account. FSA’s are a “use it or lose it”, meaning if you do not spend the money in your account, you lose it. However, you do have a rollover feature that allows you to rollover up to $640 from one year to the next.

Pre-tax contributions can also be made to pay for certain expenses to care for dependent children up to the age of 13. Expenses must be incurred at a licensed child care facility. It can also apply to adult day care for senior dependents living with you, such as parents. The Dependent Care FSA is federally capped at $5,000 per year per couple.

You can be reimbursed up to the amount you have contributed to this account. If you file a claim that exceeds this amount currently in your account, the rest of the claim will be paid as more money accumulates in the account. This is a “use it or lose it”, and changes in care giving arrangements, without a qualifying event, will not allow for an increase or decrease in your contribution amount.

• Log into your online account at www.DBSbenefits.com
• Select the Benefit Plan Type
• Select “Claims – Claims View/Submit – Submit”
• Complete the required information
• Attach an image with supporting document
• Click submit

• Download the app from Google Play or the App Store
• Log in using your ASAP name and password, clink “file a Claim”
• Take a picture or use an existing photo, click “Attach Image”
• Select the Benefit Plan Type
• Enter dollar amount, answer questions, click “Submit”

• Download a claim form at www.DBSbenefits.com
• Select the “Participant Resources Tab – Forms”
• Complete the form and attach copies of your documentation
• Mail to Diversified Benefit Services, PO Box 260, Hartland, WI 53029
• Or fax to 262-367-5938