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FSAFEDS Dependent Care FSA claim form along with itemized receipts or other ... listings of eligible medical expenses, please see Eligible Expenses at www.
HEALTH CARE FSA ... An eligible dependent is defined as a spouse, qualifying child, or ... For a complete list of eligible expenses specific to your plan, log.
To view a detailed list of eligible dependent care expenses, visit. FSAFEDS Eligible Expenses Juke Box at www.FSAFEDS.com. In general, the following rules ...
Use this form to request reimbursement for your health care expenses only. ... are partially covered by your (or your dependent's) medical, dental or vision plans, ...
May 8, 2011 - Complete a Dependent Child Care FSA Claim Form. 2. Attach itemized receipt(s) or have your. Dependent Care Provider certify the expense(s).
Dependent Care FSA, any money remaining in your FSA after March 15 will be forfeited because it ... claim forms are available at: https://www.fsafeds.com.
FSAFEDS Program ... reimbursement from your Flexible Spending Account. 3. ... Please note on the form if the expense(s) are not covered by your health, dental, or vision plan. ... The annual amount of
With an FSAFEDS flexible spending account, you save ... includes child care subsidy amounts and other FSA dependent care accounts ... not eligible eXpenSeS.