Get the free Health Care Flexible Spending Account Request for Change in Status - benefits umich

This document is a request form for faculty or staff members at the University of Michigan to change their Health Care Flexible Spending Account (FSA) elections due to a qualifying family status change.

How to fill out health care flexible spending

How to fill out Health Care Flexible Spending Account Request for Change in Status

1. Obtain the Health Care Flexible Spending Account Request for Change in Status form from your HR department or benefits administrator.
2. Enter your personal information, including your name, employee ID, and contact details at the top of the form.
3. Indicate the specific change in status you are reporting, such as marriage, divorce, birth of a child, or loss of other health coverage.
4. Provide documentation to support your request, such as a marriage certificate, birth certificate, or termination notice from the previous health plan.
5. Review the form for accuracy and completeness to avoid any delays in processing your request.
6. Submit the completed form and documentation to your HR department or the benefits administrator within the required time frame.
7. Keep a copy of the submitted form and any supporting documents for your records.

Who needs Health Care Flexible Spending Account Request for Change in Status?

1. Employees who experience a qualifying life event, such as marriage, divorce, birth or adoption of a child, or loss of other health coverage, and need to make changes to their Health Care Flexible Spending Account.

People Also Ask about

Can you cancel a flexible spending account?

To change your FSA contributions, complete and submit a Request for Change in Status form. In most plan years, certain qualified changes in status may provide an opportunity in which you may start or stop participating, or change the amount of your FSA contribution during the plan year.

Can you change your flexible spending account?

Generally, you cannot change the elections you have made after the beginning of the plan year. However, there are certain situations where you can change your elections. These situations are defined by the IRS and outlined in the plan's Summary Plan Description (SPD).

What happens to FSA if you don't use it?

The IRS created the ""use or lose"" rule, which states that all money left in your FSA is forfeited after the benefit period ends . If you don't use all of your FSA funds during the benefit period, you risk losing money.

How to get rid of FSA?

Unused funds go to your employer, who can split it among employees in the FSA plan or use it to offset the costs of administering benefits. Under no circumstances can your boss give the money back to you directly, according to IRS rules. Once the plan year is over, that money is gone.

How do I stop a flexible spending account?

To change your FSA contributions, complete and submit a Request for Change in Status form. In most plan years, certain qualified changes in status may provide an opportunity in which you may start or stop participating, or change the amount of your FSA contribution during the plan year.

What does health care flexible spending account mean?

A Flexible Spending Account (FSA, also called a “flexible spending arrangement”) is a special account you put money into that you use to pay for certain out-of-pocket health care costs. You don't pay taxes on this money.

Can I stop FSA contributions?

You can change your FSA elections during two periods: Annual open enrollment. This is the time each year when you can start, stop, increase, or decrease your FSA contributions. Qualifying life event (QLE) changes.

Does a flexible spending account affect social security?

Contributions to the FSA may reduce your social security taxes. If so, based on current social security law, social security benefits at your retirement age may be slightly less as a result of your participation in the FSA program.

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What is Health Care Flexible Spending Account Request for Change in Status?

The Health Care Flexible Spending Account Request for Change in Status is a form that allows participants to report changes in their family or employment status that may affect their eligibility or contributions to a health care flexible spending account.

Who is required to file Health Care Flexible Spending Account Request for Change in Status?

Employees who have experienced a significant life event, such as marriage, divorce, birth or adoption of a child, or a change in employment status, are required to file this request to update their flexible spending account information.

How to fill out Health Care Flexible Spending Account Request for Change in Status?

To fill out the Health Care Flexible Spending Account Request for Change in Status, individuals need to provide personal information, describe the change in status, and submit the form to the appropriate benefits administrator or HR department, along with any required documentation.

What is the purpose of Health Care Flexible Spending Account Request for Change in Status?

The purpose of the Health Care Flexible Spending Account Request for Change in Status is to ensure that participants can update their account to reflect any qualifying life changes, allowing them to adjust their contributions and benefits accordingly.

What information must be reported on Health Care Flexible Spending Account Request for Change in Status?

Information that must be reported includes the participant's personal details, nature of the change (e.g., date of event), and any supporting documents that verify the change in status, such as marriage certificates or birth certificates.