FSA - Flexible Spending Account

ENROLLMENT DEADLINE IS MAY 1, 2024 - The plan year is July 1 through June 30 each year.

(Please note: Your fiscal year enrollment allows for a grace period, which is an extra 75 days at the end of the plan year to spend down the prior year’s available balance.)
 

• Enrollment Form

• Open Enrollment Flyer

• Health Care Expense Claim Form - verify address with HR/Erin

• Dependent Care Information

• Dependent Care Claim Form

• FSA Prepaid Benefits Card Information
   

• Eligible Expenses

• OTC Expenses Eligible

• FSA Store - Eligible Products & Services (an A-Z look-up tool)