Benefits Plans - Flexible Spending Accounts: Dependent Care -
Dependent Care Expenses Worksheet

Print this worksheet is to help you estimate your dependent care expenses, or use the PayFlex Dependent Day Care Expense Planning Worksheet.

Type of Expenses Expenses You Paid Last Year Estimated
Expenses
You will pay
Infant/toddler    
Preschool    
Before-school and/or after-school care    
Reporting days (child in school only half day)    
School holidays and vacations    
Summer day camp*    
Elder care    

* These expenses must be at a comparable level to other types of providers of day care. Expenses for overnight camps are not reimbursable.

Next: Filing Claims for Flexible Spending

Limitations
The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.