2010 Flexible Spending Account Enrollment Form doc - slc: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name and Social Security number clearly in the designated fields at the top of the form.
Fill in your address accurately to ensure proper communication regarding your enrollment.
Select your status by checking either 'Guest Faculty', 'Regular Faculty', or 'Staff' as applicable.
Decide on your deduction preferences for unreimbursed medical benefits and dependent care. Enter the desired amounts in the provided fields, ensuring they do not exceed the limits set forth.
Indicate how you would like deductions to be taken (monthly, semi-monthly, or weekly) and specify a start date for these deductions.
Review all entries for accuracy before signing and dating the form at the bottom to confirm your understanding of the terms outlined.

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Do I get a form for my FSA?

The funds in your Medical and Dependent Care FSA are deposited pre-tax and the amount is deducted from your Annual Gross Income. This will be represented on the W-2 you receive from your Employer for tax reporting. There are no additional tax forms issued for the FSA plans.

How to use previous year FSA?

The grace period allows an additional 2 1/2 months to incur dependent care or adoption-related expenses. You can use any funds remaining in your account after the plan year ends to pay for expenses incurred between January 1 to March 15 of the following year.

How do I look up my FSA account?

Many TPAs offer FSA information online. You should ask your TPA about documentation known as a Summary Plan Description, which contains important details about the benefits included in your FSA account. Our FSAstore.com customer service team often gets requests to look up personal FSA balance information.

How do I access my FSA account online?

Your FSA in the Palm of Your Hand Youll love the convenience of the FSAFEDS app! Its free, and the quickest way to manage your FSA. With the app, you can: Check your balance.