Medical FSA Worksheet

Access this worksheet from the Medical FSA screen in the Life Events/New Hires process.  

When do I use the Medical FSA Worksheet?

Use the Medical FSA Worksheet when you must enter your estimated out-of-pocket expenses for insurance deductibles, prescription drugs, vision care, and any other relevant categories.

To estimate your FSA expenses:

1. In the appropriate category fields, enter your estimated out-of-pocket expenses for insurance deductibles, prescription drugs, vision care, and any other relevant categories. Your entries automatically total in the field at the bottom of the column.

2. To use the total amount of your estimates, click Use Estimate. Your total estimate figure carries over to the Medical FSA table.

Or

To exit the worksheet without using your estimates, click Cancel to return to the Medical FSA screen.

Amounts entered on the Medical FSA worksheet are not saved to the database.