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PEE HIP FS AEA 7/19ACTIVE MEMBERS INFLEXIBLE SPENDING ACCOUNT ENROLLMENT APPLICATION Public Education Employees Health Insurance Plan. O. Box 302150 Montgomery, Alabama 361302150 334.517.7000 or 877.517.0020
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How to fill out flexible spending account enrollment

How to fill out flexible spending account enrollment
01
Obtain the flexible spending account enrollment form from your employer.
02
Read the form carefully and make sure you understand the terms and conditions.
03
Fill out all the necessary personal information, such as your name, address, and social security number.
04
Indicate the type of flexible spending account you want to enroll in, whether it is a health care FSA or dependent care FSA.
05
Determine the amount of money you want to contribute to your flexible spending account for the upcoming year.
06
If required, provide documentation or proof of eligibility for certain expenses, such as dependent care expenses.
07
Review the completed form to ensure all information is accurate and complete.
08
Sign and date the form.
09
Submit the filled-out form to your employer before the enrollment deadline.
Who needs flexible spending account enrollment?
01
Employees who anticipate having out-of-pocket medical expenses that are not covered by their health insurance plan.
02
Employees who have dependent care expenses, such as child care or elder care expenses.
03
Employees who want to save money on eligible expenses by using pre-tax dollars.
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What is flexible spending account enrollment?
Flexible spending account enrollment allows employees to set aside pre-tax funds to pay for eligible expenses such as medical costs or childcare.
Who is required to file flexible spending account enrollment?
Employees who are eligible for a flexible spending account as part of their benefits package are required to file enrollment.
How to fill out flexible spending account enrollment?
Employees can typically fill out flexible spending account enrollment forms online through their employer's benefits portal or during open enrollment periods.
What is the purpose of flexible spending account enrollment?
The purpose of flexible spending account enrollment is to help employees save money on eligible expenses by using pre-tax dollars.
What information must be reported on flexible spending account enrollment?
Employees may need to report their desired contribution amount, eligible dependents, and any specific expenses they plan to use the funds for.
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