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Flexible Spending Accounts Open Enrollment

Open Enrollment Grahic

Open Enrollment Period
May 07, 2018 - May 18, 2018


Premium Conversion Account - allows you to pay your health and dental insurance premiums with pre-tax dollars. Once you enroll, you do not have to re-enroll each year.

Health Care Reimbursement Account - allows you to set aside up to $2,650 from your paycheck, pre-tax to pay for out of pocket health care expenses. You must re-enroll in this program each year.

Dependent Care Assistance Account - allows you to set aside up to $5,000 from your paycheck, pre-tax to pay for all of your eligible dependent day care expenses. You must - re-enroll in this program each year.

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***IMPORTANT INFORMATION***

  • Open Enrollment will be for Plan Year of 7/1/2018 - 6/30/2019.
     
  • The funds are available to you until June 30th, 2019. If you do not use the funds you allocated for this plan year by June 30, 2019, you will lose them - so please plan accordingly!
     
  • The contribution amount you select, up to the maximums listed above, will be spread evenly throughout the plan year, which consists of 52**pay dates. Please ensure that the math is correct, that is:

Your Contribution Per Pay Period X 52 equals the Total Election

**School nurses are based on 43 pay dates, please use the School Term Open Enrollment Form below

  • If you are currently enrolled in the City's High Deductible Health Plan (HDHP) with a Health Savings Account (HSA), or if you plan to enroll in the HDHP with an HSA effective 7/1/2018, you cannot enroll in the Health Care Reimbursement Account. Per IRS regulations, you cannot contribute to both a Health Savings Account and a Health Care Reimbursement Account during the same plan year.

Online Enrollment

  • Employees currently on the Flexible plans will have the option to enroll online.  New employees and current employees enrolling for the first time will be required to complete paper enrollment forms. 

    If you are able to, please do the online enrollment; it is the most efficient method for you and Benefit Strategies.

  • If you enroll online, you must print out your confirmation page and submit it to your payroll clerk. Please ensure that your name is visible on the form.

SEND YOUR FORMS OR CONFIRMATION PAGE TO YOUR PAYROLL CLERKS NO LATER THAN MAY 18, 2018

INFORMATION

FORMS

  • Flexible Benefit Open Enrollment Form
    All employees except School term employees use this form to enroll in the Flexible Spending Accounts for plan year 7/1/2018 - 6/30/2019. It is based on 52 weeks.
     
  • School Term Flexible Benefit Open Enrollment Form
    School term employees only (school nurses) use this form to enroll in the Flexible Spending Accounts for plan year 7/1/2018 - 6/30/2019. It is based on 43 weeks.
     
  • Direct Deposit Authorization Form
    This is the form to use to request that your reimbursements for your Health Care Reimbursement Account or Dependent Care Assistance account be directly deposited to your specified checking or savings account.
     
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