Benefits Use Medical FSA Worksheet

Use the Medical FSA Worksheet to estimate how much money to set aside for unreimbursed medical expenses for the new calendar year.

Medical expenses include out-of-pocket expenses for insurance deductibles, prescription drugs, vision care, and other similar expenses.

To use the worksheet, complete the following steps:

1. During the Benefits Enrollment or Life Events process, go to the Medical FSA screen.
2. Click FSA Worksheet.
3. In the appropriate category fields, enter your estimated out-of-pocket medical expenses.

   Your entries total automatically at the bottom of the screen.

4. Click Use Estimate if you want your estimated total amount to be entered on the Medical FSA screen, or click Cancel to discard your estimated total amount.

   If you click Cancel, nothing is saved.