Health Care Reimbursement:
Use Pre-tax dollars for a variety of qualified health care expenses incurred by you and your family members, such as annual medical insurance deductibles, co-pays, out of pocket medical expenditures and orthodontia. The maximum pre-tax deduction is $2,600 annually. Any unused funds will be forfeited back into the plan, per IRS regulations. Please be aware of American Fidelity's runoff period and grace period.
Dependent Day Care Reimbursement:
The plan will enable you to pay for your employment related child or dependent day care expenses with "before-tax" dollars. You may use this account if you have eligible dependents that require care either inside or outside of your home. Dependents are children under the age of 13 who qualify as tax dependents, or your children, spouse , or other dependent of any age who is physically or mentally unable to care for themselves. The maximum pre-tax deduction is $5,000 annually. Any unused funds will be forfeited back into the plan, per IRS regulations.
You can enroll in these plans as a
new hire or each year during Open Enrollment.
- The IRS requires that these plans have new enrollments EACH PLAN YEAR. To enroll you will need to make an appointment with American Fidelity, please call 866/523-1857 x 219 or 397.
- You cannot change or revoke your compensation amount during the plan year unless you have a life event change. Be sure to review the runoff period and grace period.
- There is no monthly fee to participate in American Fidelity's FSA plans
American Fidelity website is americanfidelity.com
where you can review any of the following options:
To check claim status you may also call 1-800-325-0654
- General Questions: call 1-800-323-3748
Healthcare Reimbursement Form
Dependent Daycare Reimbursement Form