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2022 Healthcare Flexible Spending Account

Like the Health Savings Account (HSA), the Healthcare Flexible Spending Account allows you to set aside pre-tax money from your paycheck to pay for eligible health care expenses, so you pay less tax per paycheck. TaxSaver is the FSA plan administrator.

You may elect the healthcare FSA if enrolled in the Mohawk Copay health plan or even if you do not enroll in a medical plan. Please note, per IRS guidelines, you are not eligible to enroll in the healthcare FSA if you are enrolled in the health savings account (HSA). You may contribute the maximum amount allowed by the IRS. Participants in the FSA Plan must re-enroll in the plan each year.

* Maximum contributions are reviewed and set by the Internal Revenue Service on a yearly basis.
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How a Healthcare Flexible Spending Account (FSA) Works

  • A set amount of money that you determine is taken out of each paycheck and deposited into an account. Federal Income and Social Security taxes will not be withheld from your contributions.
  • Your annual before-tax FSA contributions are deducted from your pay in equal amounts during the plan year of January 1, 2022 to December 31, 2022. The maximum allowable contribution for Healthcare FSA is $2,750.
  • Use the money in this account to pay for eligible out-of-pocket health care, dental and vision expenses for yourself, your spouse, your children or for any person you claim as a dependent on your federal income tax return. Expenses include deductibles, coinsurance and co-pays. See a list of eligible expenses below.
  • A debit card will be sent to you which provides a convenient way to pay for eligible expenses and eliminates the need to file claim forms or paying out of pocket at health providers that accept the debit card. For those providers who do not accept the debit card, you will pay at the time of transaction and complete a claim form to request reimbursement.
  • You can use your Healthcare FSA for expenses (including deductibles, coinsurance and copays) incurred between January 1, 2022 and December 31, 2022. FSA funds do not roll over from year to year, so if you do not submit an FSA expense by March 31, 2023 (for expenses incurred 1/1/22- 12/31/22), you will lose the 2022 FSA funds.
  • FSA funds cannot be used to purchase over-the-counter medicine and drugs without a prescription from your doctor. If you have a prescription for an over-the-counter medicine, you must pay out of pocket at point of sale and then submit a claim requesting reimbursement. If you do not have a prescription for an over-the-counter medicine, you must pay out of pocket for the item. Over-the-counter medications include (some of the following) - acid controllers, allergy & sinus, baby rash ointments/creams, pain relief, sleep aids and more.
  • You may use FSA funds to purchase over-the-counter items that are not considered a medicine or drug, such as bandages, splints and contact lens solution, among other items.

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Eligible and Ineligible Expenses
Examples of ELIGIBLE FSA Expenses     Examples of INELIGIBLE FSA Expenses
  • Deductibles;
  • copays from your medical;
  • prescription drug;
  • dental plans & expenses - including braces
    (orthodontics) / vision plans & expenses;
  • acupuncture;
  • birth control pills;
  • Non-medically supervised programs to
    stop smoking or lose weight
  • Non-medically necessary cosmetic surgery
  • Non-prescription sunglasses
  • Premiums for other medical plans
  • Dietary supplements and cosmetic remedies
Additional Healthcare Flexible Spending Account Details
  • The Internal Revenue Service (IRS) governs FSA plans.
  • If you take a federal tax deduction because your unreimbursed medical expenses exceed 7½% of your adjusted gross income, you may not claim the same expense on your FSA.
  • If you leave your job, your contributions will end with your last paycheck unless you elect COBRA coverage under the FSA and contribute after-tax money. If you have funds left in the FSA when you leave and you do not elect COBRA, you can continue to be reimbursed for expenses incurred before your termination date.

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How to File a Claim

You can mail, fax or file a claim online:

TaxSaver Plan, PO Box 609002, Dallas, TX 75360

Fax to: 214-528- 8122

Online at

Additional Links & Information

pdf button FSA Claim Form

pdf button TaxSaver Flexible Spending Guide

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Contact TaxSaver or the Benefits Service Center

TaxSaver | 800-328-4337 | | Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Benefits Service Center | 1-866-481-4922