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© Hitesman & Wold, P.A. 2019 Cafeteria Plan Summary Description (3-11) 24 This maximum is reduced if any of the following situations exist: (a) if you are married and reside together with your spouse, but file separate tax returns, the maximum is reduced to $2,500 (and only one parent may submit claims for reimbursement under the Dependent Care FSA); or (b) if you or your spouse have earned income less than $5,000 per tax year, the maximum is reduced to the lesser of your earned income or your spouse's earned income. Note: The Dependent Care FSA Plan’s maximum described above is also the maximum amount of employer-provided dependent care benefits that are excludable from income. If you are married, the maximum tax exclusion applies on a combined or aggregate basis. Accordingly, if your spouse has a dependent care program available through his or her employer, the maximum annual tax exclusion will apply to the combined benefits received by your spouse under his/her employer’s program plus the benefits you receive under this Dependent Care FSA Plan. It is your responsibility to monitor your combined maximum benefits and to report any benefits in excess of the maximum on your income tax return. NOTE: If your spouse is a student or is incapable of caring for himself or herself , in general, you spouse will be deemed to have earned income of not less than $250 per month if you have one Qualifying Individual or $500 per month you have two or more Qualifying Individuals. 4.5 Who is a “Qualifying Individual” for whom I can submit claims for reimbursement? NOTE: The rules are not the same as the tax deduction or exemption rules. It is your responsibility to determine whether you can request reimbursement for expenses incurred with respect to a particular individual. As discussed below, special rules apply in some cases. For additional information, please contact the Plan Administrator or your tax advisor. General Rule. Subject to the two special rules described below, y ou may be reimbursed for Eligible Expenses incurred with respect to any “Qualifying Individual.” A Qualifying Individual is a person described in paragraph (a), (b), (c), (d) or (e) below. (a) Your “child” who: (1) is under age thirteen (13); (2) has the same principal place of abode as you for at least one-half of the year; (3) does not provide over half of his/her own support during the year; and (4) is a citizen, national, or resident of the United States, or a resident of Canada or Mexico (b) Your “child” who: (1) is mentally or physically unable to care for himself or herself; (2) has the same principal place of abode as you for at least one-half of the year; (3) does not provide over half of his/her own support during the year;