A Flexible Spending Account (FSA) allows the employee to use tax-free dollars for amounts they pay for health and/or dependent care expenses that are not paid for by insurance, their employer or any other source.  The annual amount the employee elects to contribute to each account will be divided into equal amounts and deducted from their paycheck before federal, state and FICA tax.  The employer also does not pay FICA on the amount of the contribution.  The employee may wish to consider the fact that because the FICA contribution will be reduced, their future Social Security benefit may be slightly reduced. 


The election an employee makes when he or she enrolls is binding for the entire plan year (January 1 to December 31) unless he or she has a qualifying status change.  Additionally, the IRS imposes some rules and restrictions on the way the employee can use FSA funds:

  • The IRS will allow $550.00 of unused funds in the health care account at the end of the plan year to be rolled over for use in the following year. This replaces the grace period that was on our plan previously. 
  • Unused amounts over $550.00 that are not used in the plan year are still subject to the use-it-or-lose-it rule and are forfeited.  
  • Employees must elect FSA each year in order to participate.


  • File a claim – an employee may complete the Claim for Reimbursement form (found below) and submit it with itemized receipts to Bukaty Companies.  Reimbursement for the employee’s expenses may be paid via check or direct deposit.  To receive reimbursement through direct deposit, the employee must complete a Direct Deposit Authorization form, found below. 
  • Flex Debit Card – issued through MasterCard, allows the employee to pay directly from his or her FSA at the point of service, eliminating the hassles associated with having to “pay twice.”  The card costs the employee $12 annually plus an additional $2 per card, which will be deducted from their FSA account.  Each card is good for three years.  There is a $5 fee to replace any lost, stolen or damaged debit cards.   

NueSynergy Information:

4601 College Blvd., Suite 280
Leawood KS 66211

Customer Service (855) 890-7239
Fax for Claims (855) 890-7238

FSA Summary Plan Description


General Website: www.nuesynergy.com

Employee Website:


    Employer ID: NUEARCH

    Employee ID: Social Security # (no dashes)


Employee Forms:

Dependent Care Information
FSA Reimbursement Form

Debit Card Information
Debit Card Enrollment Form 

Employee Termination – FSA Choices Form

Parish Forms:
Please run a Deduction Listing Report for FSA and DCA deductions in Paylocity to determine the amount that should be remitted to NueSyergy.  Please send a copy of the Deduction Listing Report with social security numbers to NueSynergy along with payment.