> From: Noelle <http://dummy.us.eu.org/noelleg> > Date: Sun, 11 Nov 2012 17:44:22 -0800 (PST) > > you can get reimbursed for co=pays? Yes. For next year (2013). > On Tue, 6 Nov 2012, Robert wrote: > > Below are the numbers I have. I think this is all I expect, unless I > > decide to get a physical exam. > > > > Paychex > > Flexible Spending Account > > Deduction Worksheet > > NOTE: This is not an enrollment form. This worksheet is intended to guide > > you through the enrollment process. > > This worksheet will help you calculate your applicable expenses and how > > much money would be in an FSA deduction each pay period. > > > > Medical/Dental/Vision Reimbursement Account > > Annual Medical Expenses, such as: > > Deductibles and co-pays $ _____________ > > Routine physical exams $ _____________ > > Prescriptions $ _____________ > > Chiropractic care $ _____________ > > Other $ _____________ > > Annual Dental Expenses, such as: > > Deductibles and co-pays $ _____________ > > Routine check-ups $ __________140 > > Orthodontia $ _____________ > > Other $ _____________ > > Annual Vision Care Expenses, such as: > > Exams $ ____________0 > > Eyeglasses $ __________300 > > Contact lenses, solutions, cleaners $ _____________ > > Other $ __________6 > > Total Estimated > > Medical/Dental/Vision Expenses > > $ _____________ + _________________ = $ __________ > > Annual Amount # of Pay Periods* Per Pay Period > > (cannot exceed > > company max.) > > > > *Weekly, 52 pay periods Biweekly, 26 pay periods Semimonthly, > > 24 pay periods Monthly, 12 pay periods > > > > FSA009 8/05