Get Put More Money In Your Wallet By Enrolling In The Flexible Spending ... - Hr Utah

Enrolling in a Flexible Spending Account (FSA) can help users save money on health and dependent care expenses. This guide provides clear instructions to navigate the enrollment process effectively and ensure you take full advantage of this tax-free benefit.

Follow the steps to fill out the form correctly.

1. Click the ‘Get Form’ button to access the enrollment form and open it in your browser or preferred document editor.
2. Read the introductory information about FSAs to understand the benefits. Make sure to familiarize yourself with the type of expenses covered under both Health Care and Dependent Care FSAs.
3. Fill out your personal information in the designated fields, including your name, address, and contact details. Ensure that all entries are accurate to avoid issues with reimbursement.
4. Select your desired contribution amount. Consider your estimated eligible expenses for the plan year to determine a reasonable pre-tax contribution.
5. Review the eligible and ineligible expenses listed for both Health Care and Dependent Care FSAs. Make a note of any services you plan to use.
6. Sign and date the form to confirm your understanding of the terms and agreement regarding contributions and reimbursements.
7. Once you have completed the form, save your changes and download a copy for your records. You may then print the form if necessary.
8. Submit the completed form as instructed. Ensure you have included any required supporting documents according to the guidelines provided.

Take the first step towards saving money on your expenses by completing the enrollment form online today.