0000014703 00000 n The entire annual amount you elect may be used at any time during the plan year and is available January 1. Create your signature, and apply it to the page. Learn about Dallas Independent School District Flexible Spending Account (FSA), including a description from the employer, and comments and ratings provided anonymously by current and former Dallas Independent School District employees. Benefits Service Center1500 Marilla StreetRoom 1D-SouthDallas, Texas 75201Phone: 214-671-6947, Option 1Fax: 214-659-7098. The out-of-pocket medical and dependent care expenses that you pay each year can quickly add up to hundreds, or even thousands, of dollars. Apply to Customer Service Representative, Procurement Manager, Account Executive and more! <> Deep integrations streamline the experience at every step. Box 661147 Dallas, TX 75266-1147 If faxing, be sure to place this form before your receipts and don't include a cover letter. %PDF-1.3 endstream endobj 71 0 obj <>stream POSTED. Visit www.hsabank.com for a list of eligible expenses and to set up direct deposit for expense reimbursement. endobj 0000266869 00000 n indicates you have dental insurance, proof HELPFUL HINTS If the receipt is handwritten, it must But first, you must participate in at least one account in order to have access to YourSpendingAccount. All rights reserved. xH&c$CNRKW3suU/gz_?];7}>xrkUeh]~e6kPU+Wqv88[w]=wg]]^~pQU:HK)\xwv};Co]qo_ h`3V}s"_G02(JH(gS^mHF*J6ic$QhneP_28|( 9RNRMU&iL\Tk+#zwV" 0000001416 00000 n 5 days ago. Box 661147 Dallas , TX 75266-1147 Effective January 1, 2020, the paragraph Titled Agent for Services of Legal Process in the Skip to Content Jobs Upload/Build Resume . %PDF-1.5 Make a difference with your change - lead with ingenuity! 8,033 open jobs for Spending accounts in Dallas. Flexible Spending. UT FLEX How to Use Your Flexible Spending Account. You are responsible for verifying your HSA was used for eligible medical expenses under the IRS tax code. Benefits Service Center1500 Marilla StreetRoom 1D-SouthDallas, Texas 75201Phone: 214-671-6947,Option 1Fax: 214-659-7098. Poll shows public support for police and fire, HB 512, OP&F hosts flag raising ceremony on Saturday Sept. 10, New app will help OP&F retirees manage Health Reimbursement Arrangement, Independent audit report shows OP&F is well run, Members Report Summer Newsletter now available, Thin Blue Line offers an ACA accredited plan that is stipend-eligible for OP&F retirees, OP&F letter to ORSC regarding HB 512 analysis, Aon rebranding to Alight Retiree Health Solutions, ORSC: OP&F outperformed own benchmarks and peers in 2021, Members Report Spring Newsletter Now Available. If you have elected to contribute to an HSA in 2022, you may also enroll in a Limited-Purpose FSA, even though both accounts may reimburse dental and vision expenses. See how we can help you reduce benefit costs, while delivering the best possible benefits experience. Keep your receipts and invoices. 7,514 Flexible Spending Account jobs available in Dallas, TX on Indeed.com. The plan helps you save money for health care and dependent care expenses. If you are not eligible for HSA contributions for example, if you are enrolled in Medicare the seed money contribution will go to an LP-FSA. 0000003723 00000 n Prescription Drugs Plan. endobj You can also make pretax contributions to your HSA, up to IRS limits, to help your account grow. Representatives are available to assist you Monday through Friday, 7 a.m. to 7 p.m. CT and Saturday, 9 a.m. to 2 p.m. CT. Disability Coverage. 0000006921 00000 n The Dependent Care FSA is used to reimburse you for certain expenses for children under age 13, or individuals unable to care for themselves. View all FAQs Savings Calculators x]Ks7Ja{ S1T)(eY,':{PllMn`( h/[(hO;Vh]J(QKSVZW>Tztrp|Xo=ATteUGGyYvwx^.-nw)jfYY]s|36tQLi86lNiO77opzv~c*Tf6vZKjx=xC.-uiSJ[jl- 6ZVA>>q&jP6b}iR4iHd(Cpu\e_'? 0000042266 00000 n Then, you may request reimbursement from the account when eligible expenses are incurred. 0000021079 00000 n It will NOT hold Dependent Care funds. New claims forms will also be sent that include updated information. hbbd``b`@H~7 1s=q_* RqYW$$cAb@D+A\/ H2e`bd =@a You are not covered by another medical plan (unless it is an HDP) or a general-purpose FSA. 65 0 obj <> endobj Posted 11/22/2019 Other News Local: (614) 228-2975 Customer Service: 1-888-864-8363 Fax: (614) 628-1777 Spending Account Claim Form TOLL FREE: 888.868.FLEX (3539) myameriflex.com uYou can submit this data via myameriflex. endstream endobj 124 0 obj <>/Filter/FlateDecode/Index[5 65]/Length 20/Size 70/Type/XRef/W[1 1 1]>>stream hbbd``b`q@ xsWF0+X D*@ !H N] !R D,X m7@D.P $,Av$dAV 414. The Section 125 Flexible Spending Account plan is administered by United Health Care (UHC). If you enroll in the HDP during annual enrollment, your employer will make a one-time cash deposit to your HSA in January. Which plans are eligible for the OP&F stipend? 2.3k. 0000029729 00000 n Short term detention pending investigation as a consequence wisconsin form, How Do I Sign Vermont Finance & Tax Accounting Document, Help Me With Sign Vermont Finance & Tax Accounting Document, How Can I Sign Vermont Finance & Tax Accounting Document, Can I Sign Vermont Finance & Tax Accounting Document, How To Sign Vermont Finance & Tax Accounting Document. Click here to view the 2023 Active Employee Benefitspresentation. However, there is a grace period ending March 15, 2023to use your 2022Medical Spending FSA or Limited Purpose FSA dollars on eligible expenses. 0000014590 00000 n zkeok:JWKmDAP#]5JGa:1Xptvoe"`lDX,RPF@\is T)0s_(,fI5"TYa-bYepFKdLH_b48 7T?CNO&>t".]0&? Job Type All; Full-Time; Part-Time; Contractor; Contract to Hire; Intern; Seasonal / Temp; Gig-Work; Date Posted 24 hours . 0000032172 00000 n TTY: 711 Your Spending Account P.O. 0000000016 00000 n Unlike Medical Spending FSAs and Limited- Purpose FSAs, Dependent Care FSAs may only reimburse expenses up to the amount you have contributed to date. 2023 Employees Retirement System of Texas. 0 BL@Ma Here's what you'll learn: d How to access your account Search Spending account jobs in Dallas, TX with company ratings & salaries. Employee Assistance Program. HlN1E+c'N^-TV3h/:L8cy Your Spending Account! Toll-free: (877) 275-4377 in interesting facts about sam houston. Blade misrepresents OP&F. Flexible Spending Accounts. << /Length 5 0 R /Filter /FlateDecode >> By law, any money left in your FSA(s) at the end of the year must be forfeited. 447 Flex Spending Account jobs available in Dallas, TX on Indeed.com. The average salary for a account manager is $66,200 per year in Dallas, TX and $12,000 commission per year. 0000050612 00000 n Download your copy, save it to the cloud, print it, or share it right from the editor. Fax: (512) 867-7438. @=2 6 0000050063 00000 n You can deposit funds in an HSA if: If you enroll in the HDP with an HSA, be sure to save receipts. 0000021016 00000 n Health care reimbursement for qualified out-of-pocket health care expenses that are not covered by insurance (i.e. You cannot submit claims for services received after your departure date. Records Building - 500 Elm Street, Suite 4100, Dallas, TX 75202 Phone: (214) 653-7638 Fax: (214) 653-7608 The out-of-pocket medical and dependent care expenses that you pay each year can quickly add up to hundreds, or even thousands, of dollars. Your Spending Account P.O. It comes complete with a debit card. these need to be directed to hrbenefits@dallascityhall.com. LOCATION. After submission, you will be asked which method of reimbursement you prefer (electronic transfer, check, etc.). Dallas, TX. Select the area where you want to insert your signature and then draw it in the popup window. The TexFlex health care FSA is administered by PayFlex Systems, Inc. To learn more about this FSA visit the TexFlex website or call TexFlex Customer Care toll-free at (866)353-9839 (TTY:711). In the United States, a flexible spending account (FSA), also known as a flexible spending Paper forms or an FSA debit card may be used to access the account funds. Box 64030 The Woodlands, TX 77387-4030 If faxing, be sure to place this form before your receipts and don't include a cover letter. Select the document you want to sign and click. 7R=nq(C(k[B%xpi 21 y?|/zg}v6eU$7H-BA9Tc.^FLx9X}*O:#f#AHCG&z7F 5$Bw 85K2qEN/F&&pf .\4h`.K"$n> 8/NkWu5W[Y% BxBifZiKb[[3S,uStWy|Kt355e9mwg\ruuh:zv$3_}D4t0jx&]Lim&ad|yQ2B$z^v:JA%NQM$_jnRLZE,O!o4z9>PjVtUV2r?MXkoL`.`oQh JssY~GhOnjV(;3Q+ E5vOC^7KWui5/fXVEn::e[n=}e:x7QD:II{g#6/:^% endobj prescription and office visit co-pays, lab fees, glasses, contacts, dental services, over-the-counter products, etc.). 6{3]b You are covered under an eligible high-deductible plan (like the HDP). 0000328120 00000 n A Health Care FSA (HCFSA) is a pre-tax benefit account that's used to pay for eligible medical, dental, and vision care expenses that are not covered by your health care plan or elsewhere. The entire annual amount you elect may be used at any time during the plan year and is available January 1. in dallas,TX. With an HCFSA, you use pre-tax dollars to pay for qualified out-of-pocket health care expenses. This is the place to take action with Your Spending Account. plans offer two major different flexible spending accounts focused on medical and dependent care expenses. 2022 Medical, Dental, Vision and Prescription Active Employees. hZrG}} Ey{S6` `$,?5VI&8O|=#dIn6%=3}vLEY0HeCtbLu*- The Medical Spending FSA, Limited Purpose FSA, and Dependent Care FSA are separate. Representatives are available to assist you Monday through Friday, 7 a.m. to 7 p.m. CT and Saturday, 9 a.m. to 2 p.m. CT. Take a look inside. Share on Facebook . Old Red Museum of Dallas County History and Culture, Community Supervision and Corrections (Adult Probation), Department of Unincorporated Area Services, Office of Homeland Security and Emergency Management, Dallas County Unincorporated Area Strategy, Vehicle Registration - VTR 68-A Inspections, Dallas Area Rapid Transit (DART) Pass Program, Colonial Life Voluntary Supplemental Insurance, Public Employees Benefits Cooperative (PEBC). hWn6wQd(eI%nWI3rq(Crn`f&bB(fbb l0\09NPL&1GA2ibt#RDK.V($;ER6``B?Cos[4#-`cng`d=ldKT-,l][`b]h|Y1&~W;F8K?8$MIL\/f`f,v[pjRI5[,fj Apply. Get access to thousands of forms. You will have 90 days following your departure date to submit claims for expenses incurred before you left. __g 5j(]c;,mKK{x FG[ojl5kzW|S^}gdhg7_/b3-. A Flexible Spending Account (FSA) allows you to save money by using "before-tax" dollars to pay for certain health care and dependent care expenses. All other questions that cannot be answered by either of <>>> by. 0000014814 00000 n endstream endobj 72 0 obj <>stream 0000059187 00000 n Funds are available three business days after payroll deduction. 0000013089 00000 n Open the doc and select the page that needs to be signed. HlTI0qgd{i*1%Mi9FzyJhTPISs7B YkO%G, (^q =75@y8)z;$|$[PTf^ kD9J #zn_1_[nF N /qR41>_,C69"YE-[akck}Ut\(:"jYMQGCPk9rtEua? =7XA2|{.X0i)i The grace period does not apply, and you may not roll these funds into a Limited Purpose FSA for 2022. The card will hold Medical Spending and/or Limited-Purpose funds. Open the email you received with the documents that need signing. Legal Information | Privacy Statement | About this Site 2023 Alight Solutions plc Glassdoor is your resource for information about the Flexible Spending Account (FSA) benefits at AT&T. Learn about AT&T Flexible Spending Account (FSA), including a description from the employer, and comments and ratings provided anonymously by current and former AT&T employees. 0000011883 00000 n 0000041865 00000 n Your Spending Accounts PO Box 661147 Dallas, TX 75266-1147 YSA will be sending official communication to members about the new address around during the first quarter of 2020. Is this useful? Contact Optum Bank for details. 0000041523 00000 n 0000238976 00000 n following: Questions regarding plan information for active/pre65: 214-556-0971. 125 0 obj <>stream 952 salaries reported, updated at January 29, 2023. Questions regarding Medicare Advantage Plan (MAPD): 877-299-1008. hb``a``d`e`sXc`A3&0tt4 1Hx7@acq! ;LA(vrE3)!AQO!)^2c^" s? k&| Anb!uZ + 0000050024 00000 n Dependent care reimbursement for costs paid to day care and elder care providers. The average salary for a account executive is $74,443 per year in Dallas, TX and $20,000 commission per year. If you use the card at an Inventory Information Approval System (IIAS) merchant, the transaction will be approved at the point of sale. The new address for YSA is: YSA will be sending official communication to members about the new address around during the first quarter of 2020. These benefits are available to full time employees only. Your Spending Account is a trademark . As of the 2010 census, the population was 2,368,139. 0000029844 00000 n Retirement Plan with Employer Match . Health Spending Accounts. Dependent Care FSA funds must be used by December 31, 2022, and all claims must be filed by March 31, 2023. Use professional pre-built templates to fill in and sign documents online faster. You may also call 214-671-6947, Option 1. ]A?~D-jF/aXdkut#F;u\#~,61'=mo/ di3{En. ,uFnPU5#kS_r,A'$$]3K ;> Records Building - 500 Elm Street, Suite 4100, Dallas, TX 75202Phone: (214) 653-7638 Fax: (214) 653-7608. |ihb0re:U6dU+!YV7Bo2^#[ IPBCP")[n$e`OLO=}o@1]Y~cWTSW;SX. Your flexible spending account (FSA) balance is yours to spend through December 31st of each year. to Your Spending Account by fax or mail: Fax: (888) 211-9900 Mail: Your Spending Account P.O. Medical Spending/Limited Purpose reimbursement requests, as well as debit card transaction documentation, can be sent electronically, by fax, or by mail to HSA Bank. Box 661147 Dallas, TX 75266-1147 Tel: (888) 611-5500 (toll free) Monday through Friday: 8 a.m. - 6 p.m. CT . 0000003548 00000 n HTK \* cJe17ioL}[8j ('96&|2"O+"q3vc$0n$v{&[zkT[R3jd3IC%I+I6;zN>*OfqQm~8M(0gngV>S(P4P 2022 Medical, Dental, Vision and Prescription Active Employees. 5y0eKL0A8+CN"Hs8vWb5x4\fG^xU"8Aj0'+jmh9C:ZL:P5#pD_W@`ain&b@$bu? trailer 0000005093 00000 n (512) 499-4200. 2023. Responsible Office(s) Employee Benefits. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Wb"77Su,1 U@k~l-[6rn20mn" =5ui{l; z|c8bz~'m>4#YWi)Ax0(a,j{Ut8i3{^H:}BWcBIa`V]_,SQ!oCC:{sa;Ua,MsNePg : N>O^Yc*:fIy ~DD&ugP}DZz$f\x.Afb2`FI`'FK1G`Ph=9/8bQom Fha\{^%t O2 I[nQx5y&bDiD6('S8SI44@gH{smBA*M:JO[ Yw7 yo6 2{dV Vision Plan. Your Medical Spending FSA may be used to reimburse out-of-pocket medical expenses for you, your spouse, and your dependents. Pension Plans. Dental Plan. Additionally, any claim forms, communications or notices generated by YSA since the change have included the new address. 0. 0000008111 00000 n Traditional Health are Flexible Spending Account*); hb``0a``K0D800 @1CKxGC/C` |FE_,sUl/001 *^#v F )" ,/+Y2Pu New claims forms will also be sent that include updated information. %%EOF Smart-Choice The Woodlands, TX 77387 Health Savings Account administration Smart-Choice Accounts PO Box 64009 -4009 Human Resources Centre (HRC): 1-888-927-7700 BMO U.S. Benefits Enrolling and making changes to your annual . Legal Information | Privacy Statement | About this Site 2023 Alight Solutions plc Unlike an FSA, there is no use it or lose it rule and it comes with triple-tax benefits: For 2023, you can contribute $3,850 through payroll deduction if you have individual coverage or $7,750 if you have family coverage. HELPFUL INTS If the receipt is handwritten, it must include the service provider's signature. HELPFUL HINTS If the receipt is handwritten, it must include the service provider's signature. Benefits of Using YourSpendingAccount. 0000001858 00000 n Search CareerBuilder for Flexible Spending Account Plan Jobs in dallas,TX and browse our platform. Read our response. JOB DETAILS. 0000010668 00000 n If the expense will be considered for insurance reimbursement, try to wait until you receive the Explanation of Benefits (EOB) from the insurance company to be sure that the debit card transaction is for the correct out-of-pocket amount. 0000037849 00000 n endstream endobj 69 0 obj <>stream You may also call 214-671-6947,Option 1. Elevate your benefits and create more value for your customers. According to Aon and YSA, any mail received at the old address is automatically forwarded to the new address. .Li{~y:^}I|fT;_5JCZcp|3!Sru~Z pMgVi5nmh9uz^n>"nx}ZgCNgug*dwFq*&L6Q{T0;`fdOw#0Lq]HG6MS9GtAlxDCqqe[:Ql:8yAf_R]-Tgr:`D:$1M"XhjOPdfw{Zh)X^a`i%P5/^boB5cwuy?dzaF81:ayBWIe'h#]TMd>mP0 &/6TkzHT=AVtQh/KV : jv4q>#Gz8vM)/ral0'IlN,wj{{_6iznq>C,9K{R\:OWmKhFvm EZu ph` F Select the area you want to sign and click. No monthly maintenance fees. endstream endobj startxref Austin, Texas 78701-2982. To comply with HSA rules, your Limited- Purpose FSA may only be used to reimburse out-of-pocket dental and vision expenses for you, your spouse, and your dependents. 1.8k salaries reported, updated at February 15, 2023. endstream endobj 71 0 obj <>/Metadata 3 0 R/Pages 2 0 R/StructTreeRoot 5 0 R/Type/Catalog/ViewerPreferences<>>> endobj 72 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/Properties<>/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 73 0 obj <> endobj 74 0 obj <> endobj 75 0 obj [/Separation/PANTONE#20137#20C 86 0 R<>] endobj 76 0 obj [/ICCBased 87 0 R] endobj 77 0 obj <>stream 0000014230 00000 n Document Type. You cannot transfer funds between accounts or charge multiple accounts for the same expenditure. 401 (k) Savings Plan. how do i choose my seat on alaska airlines? All rights reserved. Apply to Administrative Assistant and more! Withdrawals made for qualified expenses are also income tax-free. hb```V\af`0pHN@9(PsH 6s+s{}p=-z{FwYn^ (4hh@3V iq -tl2J870dNl`g*aQw\4uy4? And free to you. Generally, large pharmacies, grocery stores, and box stores (i.e. 1) Register or log into your employer's Spending Account website. 0000005496 00000 n to Your Spending Account by fax or mail: Fax: (888) 211-9900 Mail: Your Spending Account P.O. You must be enrolled in a high-deductible health plan to participate. 108 0 obj <>stream 0000240494 00000 n Members Report Fall Newsletter Now Available, OP&F Pre-Retirement Webinar video now available. .`9\Bs(|+p*l8=+)n'W=rj94 .E~u==&$b4lny^|l *DgN69pvhRk'[y|~^y,x1T`TM~7rn>:4ee&:.sX1&9EX!YT0rV)E^b,q$YcaSJT [0fURCQ"5Z 0000021227 00000 n 0000029666 00000 n Start completing the fillable fields and carefully type in required information. Your spending account is your checking account. There are three variants; a typed, drawn or uploaded signature. See IRS Form 2441 Part III for details. to Your Spending Account by fax or mail: Fax: (888) 211-9900 Mail: Your Spending Account P.O. %%EOF Decide on what kind of signature to create. Dallas County is a county located in the U.S. state of Texas. 0000009380 00000 n kiL/o0[~A(V-+>%ieoUaooeyl \ Its county seat is Dallas, which is also the third-largest city in Texas and the ninth-largest city in the United States. 102 0 obj <>stream Dependent Care FSA is for dependent daycare only. If you retire or otherwise leave City employment, your FSA funds will terminate on the date of your departure. Find the extension in the Web Store and push, Click on the link to the document you want to design and select. 3) After selecting "Documents and Forms" you will be directed to a screen that looks similar to the image below. Dallas, TX. An HSA is a savings account that you can use to help cover qualified health care expenses. 3 0 obj Ohio Police & Fire Pension Fund. 0000050141 00000 n Questions regarding plan information for active/pre65: 214-556-0971. Contact Us | Help | Privacy Policy | ADA Statement. "b!bULZX |fX3X6{. If youre are enrolled in Consumer Directed HealthSelect and are interested in setting aside money on a pre-tax basis for eligible dental and vision expenses, check out the TexFlex limited-purpose FSA. After that, funds in excess of $570 will be lost so be sure to use them while you can. 90 0 obj <>/Filter/FlateDecode/ID[]/Index[65 44]/Info 64 0 R/Length 111/Prev 468601/Root 66 0 R/Size 109/Type/XRef/W[1 2 1]>>stream 42 0 obj <> endobj Eligibility for the OP&F health care stipend: what to do when you have aQLE, Options available for retirement interviews, IRS using new versions of W-4P, W-4R for 2023 tax year, Member's Report Winter Newsletter Now Available. All claims must be submitted by March 31, 2023. Box 64030 The Woodlands, TX 77387-4030 If faxing, be sure to place this form before your receipts and don't include a cover letter. Sending Your Claim to Your Spending Account Send this form and your documentation to Your Spending Account by fax or mail. . 0000038345 00000 n You may be required to submit documentation of your expenditures. No minimum balance fees. 0 HVnF|Wt8V`Hv^{PXfLOuuP@^,rOnEC'/\R@gg//hy<8 lN~N 0$xXOR~uJV:5y~DR s?gPo ;"U/|xu`VJ0|5wlrg8lU>?9x@7:H.>%e^q`{yu74u{~P@@' OLEB~(((N@K? FG U%KPc4WJ+ Dallas, TX 75234 1 972-243-6191 ClubCorp on facebook; ClubCorp on instagram . /YRxFI. Get Form 0000050880 00000 n The maximum annual Limited-Purpose FSA election is $2,750. Box 661147 Dallas, TX 75266-1147 If faxing, be sure to place the form before your itemized receipts and don't include a cover letter. 0000021193 00000 n FLEXIBLE SPENDING ACCOUNTS (FSA) The Flexible Spending Accounts (FSAs) allow you to pay for eligible healthcare and dependent care expenses using tax-free dollars - money taken out of your paycheck before income or Social Security taxes have been calculated. No fees at TCCU ATM's. Spend your days in paradise or spend some love to a special someone. }@2D8inx%'\#d;aT n$M4IAWDHl|"I@*x/#28}}?Qoe?IU6b3hM v':H,! . Search for the document you need to design on your device and upload it. Flexible Spending Accounts. Look through the document several times and make sure that all fields are completed with the correct information. Dallas County is joined with a cooperative insurance group along with other city and county agencies. If your account balance is $2,000 or more, you can choose to invest funds look for details in your Welcome Kit. 70 0 obj <> endobj Add the PDF you want to work with using your camera or cloud storage by clicking on the. 0000002565 00000 n your spending account dallas, tx. 0000002001 00000 n Your FSA funds may be used for qualified medical costs like copays and deductibles, prescriptions and some over-the-counter medicines, dependent care and more. This benefit allows you to deduct money from your paychecks for: For additional information, please visit the Public Employees Benefits Cooperative (PEBC)website atwww.pebcinfo.com. Go to the Chrome Web Store and add the signNow extension to your browser. Claims are normally reimbursed within a week of HSA Bank receiving the claim. Eligible expenses include deductibles, coinsurance and prescriptions. O;T >E *8x)R}3ABlVeIoB~YC7=g=_SId8X UZKX As long as you maintain an account balance of $500 or more, you will not be charged the $1 monthly account maintenance fee. 0000032931 00000 n If you have a Your Spending Account online, you will be able to: 0 Glassdoor is your resource for information about the Flexible Spending Account (FSA) benefits at Dallas Independent School District. This guide will help you get started with Your Spending Account (YSA) a website you can use to manage your retiree Health Reimbursement Account (HRA) whenever and wherever it's most convenient for you. $ bL4FMHjDS{=EnWPLDR*Z}TT#Z%YHg H-djcLYb-yBHMHVj6dg'W"XAHpFHicHF &?_$P $YlyEr,X)nCwew &(vIDk9@UUXWo59.AXVI&G{1Iu! Hs C:rtU* gq5M-SPLDIZ . <<345A0DA70B0308418CEB8C1CDDA1C003>]/Prev 332151/XRefStm 1690>> Employer Name: Employee Name: SSN: Phone: Email: Medical Expense Claims (FSA, or Employer funded HRA) Dependent Day Care Claims Account Type FSA HRA Date Expense Incurred Name of Person Receiving Medical Service Provider Name endstream endobj startxref Ordinarily, these expenses are paid with after-tax money. Records Building - 500 Elm Street, Suite 4100, Dallas, TX 75202. Note: If you currently participate in the Medical Spending FSA and elect the HSA medical plan for 2022, your FSA funds will expire on December 31, 2021.
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