Flexible Spending Account (FSA) Calculator

Important Notice: the Principal Financial Group^® will not capture, record, nor use for its own commercial purposes the data elements entered by you into this calculator

Should I enroll in my Company's Flexible Spending Account Program?

The following worksheet will help you estimate your potential tax savings by signing up for a Flexible Spending Account.

What is your Annual Income?

Health Care Reimbursement Account

Enter the amount of your medical plan deductible:

Enter the average medical co-insurance you pay each year and out of pocket medical expenses:

Enter the amount of your dental plan deductible and out of pocket dental expenses:

Enter how much do you pay for eyeglasses, contact lenses, contact lens solution and vision exams each year?

How much do you pay for orthodontia expenses each year?

Enter the amount you spend on prescription drugs not covered by insurance:

Enter any other yearly eligible expenses for which you might pay:

Dependent Care Reimbursement Account

Enter the amount of day care you normally pay annually:
(For children under the age of 13, or other dependents [spouse or similar member] living in your home who require daycare or adult day care. These could include Daycare Center, Babysitter and/or Nanny. The current maximum amount allowed under IRS guidelines is $5000.)

Results

Annual Medical Contribution:
Annual Dependent Care Contribution:

	With Spending Account	Without Spending Account
Annual Income
Estimated Health Care Expenses:
Estimated Dependent Care Expenses:
Taxable Income:
Net Pay:
*Assumes 15% federal income tax, 5% state income tax and 7.65% Social Security tax.

Check Potential Tax Savings

*Your tax savings will be approximately annually by using a Health Care Spending Account.

*Your tax savings will be approximately annually by using a Dependent Care Spending Account.

For most individuals, the tax savings from using a Health Care Reimbursement Account will significantly exceed the tax credit allowed if you claimed these expenses on your income tax form. Without an FSA, you can only deduct health care expenses that exceed 7.5% of your Adjusted Gross Income on your income tax form. Because FSAs are tax free from the first dollar you do not have to meet the 7.5% minimum in order to receive the tax advantage.

IN 16499
12/2004