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Dependent Day Care FSA

Guidelines, Policies & Forms

Dependent Day Care FSA Claim Form

If you have questions regarding your existing flexible spending account, contact TASC:

  • Online at the TASC website
  • By phone at 855-842-4913, Monday-Friday 8 a.m. to 5 p.m.

Frequently Asked Questions

Child Care Subsidy Grant (CCSG) Program 

Stanford’s Child Care Subsidy Grant (CCSG) is a university contribution to your Dependent Day Care FSA. If you receive a CCSG amount, it will be included in your total Dependent Day Care FSA annual amount.

Learn more about CCSG

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Stanford Benefits is partnering with Fidelity Investments® to administer its Health Savings Account (HSA) and Flexible Spending Accounts (FSAs), including our tax-free Child Care Subsidy Grant (CCSG) facilitated by the Dependent Day Care FSA effective Jan. 1, 2024.

The Dependent Day Care FSA provides for reimbursement of eligible day care expenses incurred by the participant.

If you elect benefits under this plan, a non-interest bearing bookkeeping account will be set up to keep a record of before-tax contributions - and where applicable, any non-elective employer contributions -  allocated to the account and the reimbursements for eligible day care expenses to which you are entitled during the plan year. No actual account is established; it is merely a bookkeeping account.

NOTE: When using the Stanford FSA debit card for dependent day care expenses, payments are limited to the amount you have accrued within your Dependent Day Care FSA at the time a claim is submitted.


Plan Information


The Dependent Day Care FSA lets you pay for eligible dependent day care expenses with pre-tax dollars so that you and your spouse can work, look for work, or go to school full time. Child care is only eligible for children under age 13. The Flexible Spending Accounts are managed by Fidelity.

If you have been awarded a Child Care Subsidy Grant (CCSG), your award will be automatically accepted for you in My Benefits and applied to your Dependent Day Care Flexible Spending Account (FSA). The amount will be included in your total Dependent Day Care FSA annual amount. The combined total of the CCSG and your contributions cannot exceed the $5,000 annual limit.

How to Enroll

Elect to participate at during the annual open enrollment period or after you have experienced a qualifying life event.

If you are a current participant and fail to re-enroll during open enrollment, your Dependent Day Care FSA will not roll over into the next plan year.

How it Works
  1. Determine the amount of unreimbursed eligible dependent day care expenses you - and where applicable, your eligible family members - will likely incur during the plan year. Keep in mind the IRS limit for pre-tax contributions to your Dependent Day Care FSA is $5,000 per household.
  2. Elect to have Stanford withhold an annual amount which will be withheld in equal amounts from your pay on a pre-tax basis for reimbursement of these expenses. Elect wisely as you forfeit any dollars remaining in a flexible spending account that you do not use for expenses incurred during the plan year. Funds are available 3-5 Business days after your paycheck in which a deduction is taken. 
  3. Submit your dependent day care claims for reimbursement.
  4. Any remaining unused dollars will be forfeited. You have until April 30 to submit claims for reimbursement from the previous plan year that ends December 31.
How to Submit Claims

You have three options for submitting your Dependent Day Care FSA claims for reimbursement:

  1. Submit your claim through the Fidelity Health app .
  2. Follow the NetBenefits Flexible Spending Accounts Service Guide 
  3. Use your Stanford FSA debit card, however, reimbursement will be limited to the amount accrued in your account at the time the claim is submitted. 


Types of Documentation

In order to submit a claim, you will need to provide documentation in one of three formats.

  1. Receipts from your Dependent Daycare Provider
  2. Receipt for Service Form from your Dependent Daycare Provider
  3. Dependent Daycare Contract

For a full description of each format, review the Dependent Daycare Substantiation Requirements document.


Frequently Asked Questions

Below are answers to the most frequently asked questions regarding Dependent Day Care Flexible Spending Account plan.

View complete list of FAQ

Dependent Day Care FSA

Who can I cover?

Generally, you can cover:

  • A dependent up to age 13 whom you can claim as a tax exemption on your federal income tax return
  • Your spouse* (not a domestic partner) who is physically or mentally unable to care for himself or herself
  • Your dependent who is physically or mentally unable to care for himself or herself, and you can claim as a tax exemption, subject to certain criteria



For details on dependent eligibility requirements, refer to IRS Publication 503. We also suggest you review Part III of the Flexible Spending Account (FSA) Summary.

Can I cover my domestic partner (or my partner’s children) under the dependent day care FSA?

Generally, you may not submit Dependent Day Care FSA claims unless your partner is considered a “qualifying relative” and a “tax dependent” according the Internal Revenue Code rules. For further guidance, please consult your tax advisor.

Your partner’s children, however, may be covered if they meet the eligibility requirements as described in the Flexible Spending Account (FSA) Summary. You can also look at these requirements in IRS Publication 503.

What kind of receipt is required for reimbursement?

You can choose from three convenient options:

1. Receipts from your Dependent Daycare Provider  

With each payment to your daycare provider, request a receipt for the service period (weekly, biweekly, monthly). The receipt should contain the following information:

  • Name of the daycare provider
  • Name of the customer (your name)
  • Name (and ages) of the children receiving care 
  • Dates of care
  • Provider Tax Payer ID/Social Security Number 
  • Receipt/Invoice Date
  • Provider’s signature or on company’s letterhead (if a daycare center)
  • Payments received (optional)

2. Receipt for Service Form from your Dependent Daycare Provider

 Instead of a custom receipt from the daycare provider, you may use a form to submit all required information. Ask your provider to complete and return the form to you. After that, simply copy, update (dates of service), and submit whenever requesting reimbursement. Download the form (Dependent Daycare Receipt for Service) from the Stanford/Partners website. 


3. Dependent Daycare Contract

If you use the same daycare provider for the entire plan year, consider completing a Dependent Daycare Contract. It serves as a receipt for the entire year (or time you’re with that provider). Complete boxes 1, 2, and 4, and your daycare provider completes box 3. You may submit the contract in one of two ways:

  • Enter the entire amount for the year on the reimbursement form and submit the contract once. TASC automatically pays from your account each time contributions are applied to your account. Or, 
  • Enter the amount for the specified time period on the reimbursement form and submit the contract each time a payment is made.

Download the form (FlexSystem Dependent Daycare Contract) from the Stanford/Partners website.


Dependent Daycare FSA requests for reimbursement must include one of the above-described receipts from your daycare provider. If you have questions or concerns, please call 1-855-842-4913, 8-5, all time zones. 

What is the maximum amount I can contribute?

The annual household dependent day care FSA maximum is $5,000 per family ($2,500 if you are married and filing separate federal income tax returns).


Each year FSA plans must pass a non-discrimination test to show they do not favor highly compensated employees regarding eligibility, contributions and benefits. If Stanford’s FSA plans do not pass the test, Stanford may reduce your election(s) during the year, if you are a highly compensated employee as defined by the Internal Revenue Code. We will notify you if it becomes necessary to reduce your contributions.

What is the Stanford FSA debit card?

The Stanford FSA debit card is a convenience feature of the FSA plan that allows you to have access to your account funds for eligible health care expenses right at the point of service—at the pharmacy counter or doctor’s office.

When you enroll in a Health Care FSA or a Dependent Day Care FSA, you will automatically receive a Stanford FSA debit card from Fidelity. You can use your card with any provider who accepts it.


When using the Stanford FSA debit card for dependent day care expenses, payments are limited to the amount you have accrued within your Dependent Day Care FSA at the time a claim is submitted. 


Are there any advantages of using a Dependent Day Care FSA instead of the Child Care Credit on my federal income tax return?

IRS Publication 503 can help you determine whether using a FSA or filing for the Child Care Credit on your tax return is most advantageous to you. The IRS will not allow you to receive two tax breaks for the same expenses. In addition, depending on your situation, you may be required to file additional forms such as Form 2441. For further guidance, consult your tax advisor.

I participate in the Stanford Child Care Subsidy Grant program. How does that affect my dependent day care FSA?

Stanford’s Child Care Subsidy Grant (CCSG) is simply a university contribution to your Dependent Day Care FSA. If you receive a Child Care Subsidy Grant amount it will be included in your total Dependent Day Care FSA annual amount. The combined total cannot exceed the $5,000 annual limit.

New in 2020, when you log into My Benefits during Open Enrollment, your CCSG award will be auto-accepted for you, and will enroll you in a Dependent Day Care FSA for the following calendar year. Once the CCSG money is in your Dependent Day Care FSA, you use it as if you had contributed the money and file claims for reimbursement of your dependent day care expenses.

Remember, you forfeit any unclaimed funds at the end of the plan year unless you submit claims by the April 30 deadline.

Learn more about CCSG

How do I receive a payment from the FSA for day care expenses?

Your reimbursement will automatically be placed in your Fidelity account which is associated with your debit card. If you would like your monies to go into a bank account go to and enter your banking information.


For questions about your claims payment, call Fidelity at 888-793-8733 Monday-Friday 8AM-5PM. Claims for reimbursement are processed daily. Reimbursement monies are payable to you, not to the provider.

I have a Dependent Day Care Flexible Spending Account. What information is reported on my W-2?

Employers report dependent care benefits in box 10 of your W-2 form. Dependent care benefits include your pre-tax contributions to your dependent care FSA. Also included are eligible amounts paid by your employer to you or to your day care provider and the fair market value of dependent care in a facility provided by or sponsored by your employer. The fair market value of dependent care services that exceed the non-taxable limit of $5,000 allowed for the FSA is listed in boxes 1, 3 and 5 of the W-2 form. You must complete Form 2441, Child and Dependent Care Expenses, to compute any taxable and nontaxable amounts.