Calculate Your Tax Savings

By completing the following information, you can calculate your annual reimbursable expenses.

Select Your Annual Income		Less than $30,000 $30,000 - $40,000 $40,000 - $70,000 Greater than $70,000
Select Your Pay Cycle		Once a Week Once Every Two Weeks Once a Month
Healthcare Expenses (estimated)
Doctor visits and co-pays	$
Deductibles	$
Prescription drugs	$
Weight-loss programs (associated with a specific disease).	$
Prescribed medical supplies/equipment	$
Travel to doctor or hospital	$
Eye exams & surgery	$
Glasses/contacts/solutions	$
Dental checkups	$
Fillings/crowns	$
Orthodontia	$
Chiropractic	$
Psychiatric or Psychologist's fees	$
Other	$
Total	$
Dependent Care Expenses (estimated)
Children	$
Adults	$
Total	$
Total Expenses
Total Healthcare Expenses	$
Total Dependent Care Expenses	$
Total Annual Expenses	$
Annual Tax Savings	$
Estimated Savings Amount Per Paycheck	$

Please note: Tax savings amounts are estimated. Please contact your tax advisor for savings amounts specific to your household earnings.