Enroll or Re-enroll to participate in Healthcare and/or Dependent Care Flexible Spending Account (FSA)

Please complete the FSA Enrollment Form. 

Additional information regarding the Flexible Spending Account benefit include:

• Enrollment in the Flexible Spending Account (FSA) plan does NOT automatically continue from one year to the next. All employees who wish to participate in Healthcare and/or Dependent Care FSA for the next plan year (July 1, 2025- June 30, 2026) MUST enroll or re-enroll during this open enrollment period.
• Benefit-eligible employees are eligible to participate in FSA plans even if they are not enrolled in other State health plans (medical, dental, etc.).
• If you have the High Deductible Plan and the health savings account and you would like to also sign up for the medical FSA you will need to make sure you are signing up for the limited health care FSA (LHCFSA).