Combined Services LLC Flexible Benefits Participants

Flexible Spending Account Calculator

How much would you like to save for your Health Flexible Spending Account (HFSA) and/or Dependent Care Flexible Spending Account (DCFSA)? Use our FSA Calculator to find out.







	Tax Look-Up

How to use the calculator:

Already have an idea of how much you want to set aside in an FSA? Follow the instructions below.
or Go to our itemized worksheet.

Enter the HFSA Election Amount and the DCFSA Election Amount into the calculator.

Skip the Pre-tax Election box (it will auto-populate once you select "Calculate".

Enter your Estimated household income and select your estimated tax bracket (use the look-up if you' re not sure).

Click the calculate button.

Your Estimated Annual Tax Savings will appear in the screen of the calculator.

* The calculator automatically adds the FICA tax percent of 7.65% to your total tax liability. If a tax bracket is not selected, the calculator defaults to 25% plus the 7.65% FICA. The calculator does not consider State tax. If you live in a state with an income tax, your savings could be even greater.

FSA Itemized Worksheet

Calculating your Healthcare Expenses Uninsured Health Costs per Year
Health Insurance Deductibles	$
Co-Insurance	$
Office Visit Co-pays	$
Vision Care (eye exams, contacts, glasses)	$
Routine Exams (Ob-Gyn, school physicals, etc.)	$
Chiropractic Services	$
Over-the-Counter Medications (view list)	$
Other (view examples of eligible expenses)	$
Uninsured Dental Costs per Year
Examinations and Cleanings	$
Braces and Retainers (Note on Orthodontia)	$
Filling, Crowns & Bridges	$
Dentures (including replacements)	$
Implants, Inlays, X-rays	$
Other	$
Total	$
Return to Calculator

More About Dependent Care FSA's The Dependent Care Flexible Spending Account is for child and dependent care expenses incurred to allow you (and your spouse if you are married) to work. The dependent on your income tax return must be under 13 (or incapable of self-care) and be claimed as a dependent. The rules for eligible expenses are the same as those for the Child and Dependent Care Credit which are outlined in IRS Publication 503.
Calculating your Dependent Care Expenses
January	$
February	$
March	$
April	$
May	$
June	$
July	$
August	$
September	$
October	$
November	$
December	$
Total	$
Return to Calculator

What to Do Next...

Once you've entered your healthcare expenses, click the "Total" button. Click "Return to Calculator" if you are done.
If you have dependent care expenses, complete the right portion of the worksheet and click the "Total" button. To go back the calculator, click "Return to Calculator".
You will then need to fill in your estimated houshold income and select a tax bracket and click "Calculate". Your estimated tax savings will appear in the screen of the calculator.