Dependent Care Flexible Spending Account (DCFSA)

The Dependent Care Flexible Spending Account (DCFSA) allows you to set aside money to pay for eligible dependent care expenses with pre-tax dollars. You can enroll in a Dependent Care FSA even if you're not enrolled in other Baker Hughes benefits.

Note: The Dependent Care FSA is for child care or elder care expenses. It is NOT for health care expenses for your dependents. Use the account to pay for child care or elder care expenses while you and your spouse work or attend school. Examples of eligible expenses include:

• Child care or babysitting
• Before- and after-school programs
• Nursery school or preschool
• Adult/senior daycare

Refer to IRS Publication 503 for a complete list of qualified dependent care expenses.

Important details

• The Dependent Care FSA may be used for eligible expenses for children under age 13 and certain elderly or disabled dependents.
• You may contribute from $200 up to $5,000 annually ($2,500 maximum if you are married and file separate tax returns).
• Funds are available as you deposit them into your account.
• Claims must be incurred during the plan year (January 1 – December 31) and submitted to UHC by March 31 of the following year to be eligible for reimbursement. 
• You will not receive an ID card for the DCFSA.
• Any money you do not use by the end of the year is forfeited.

Payroll deductions

The amount you elect to contribute to your FSA during Annual Enrollment will be deducted from your paycheck. You will not be able to make adjustments to your DCFSA contributions after November 1 of the plan year.

How to file claims

There are two ways to file your claim: online or paper claim form.

Online claim form

If you submit a claim using the online claim form on myuhc.com, UHC will typically reimburse you 2-3 days after the claim is processed. Here’s how to file an online claim form:

• Go go myuhc.com and log in or create an account. (To create an account, click Register Now. You can register using your Social Security Number and date of birth.)
• Once you’re logged in, click Claims & Accounts, then click Submit a Claim.
• Follow the prompts to fill out the form and submit it.

Paper claim form

Print the online claim form and then mail or fax it along with your receipts.

Mail to:

Health Care Account Service Center

P.O. Box 981506

El Paso, TX 79998-1506

Fax: 1-915-231-1709

Toll-free fax: 1-866-262-6354

Check the Status of Your Claim

Go to myuhc.com or call UHC at 1-866-743-6549.

Accessing your account

If you are currently enrolled in a Baker Hughes UnitedHealthcare (UHC) Medical plan, go to myuhc.com to log in. Click on View Account Balances.

If you are not currently enrolled in a Baker Hughes UHC Medical plan, you will use your Social Security Number and date of birth to create a myuhc.com account. Click on View Account Balances once you are logged in.

You can access your UHC account online from a desktop or laptop computer, tablet, or your mobile phone. Go to myuhc.com and/or download the UnitedHealthcare app to:

• Submit claims via the online claim form
• Track account balances and spending
• Set up direct deposit for reimbursement

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