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20202021 Medical Plan Enrollment and Change Form
Graduate Medical Education Residents and Fellows
Enrollment is required for residents and fellows in job codes 9556, 9559, 9582, 9583, 9555, 9554,
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How to fill out flexible spending accounts enrollment

How to fill out flexible spending accounts enrollment
01
Step 1: Gather all necessary documents and information, including your employee ID, social security number, and documentation for any dependents you wish to include in the enrollment.
02
Step 2: Review the enrollment form and understand the options available to you, such as the contribution limit, eligible expenses, and any deadlines for submitting claims.
03
Step 3: Fill out the enrollment form accurately, providing all required personal information and specifying the desired contribution amount.
04
Step 4: Attach any supporting documents, such as proof of dependent eligibility, if required.
05
Step 5: Double-check all the information entered before submitting the enrollment form.
06
Step 6: Submit the completed enrollment form and any supporting documents according to the provided instructions. Make sure to keep copies for your records.
07
Step 7: Monitor your flexible spending account throughout the year, keeping track of eligible expenses and submitting claims as needed.
08
Step 8: Familiarize yourself with the reimbursement process and any required documentation for claim submission.
Who needs flexible spending accounts enrollment?
01
Employees who want to take advantage of pre-tax deductions for eligible medical, dental, and vision expenses.
02
Individuals with predictable healthcare or dependent care expenses who can estimate their costs for the year.
03
Employees who want to save on taxes by reducing their taxable income through contribution to a flexible spending account.
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What is flexible spending accounts enrollment?
Flexible spending accounts enrollment refers to the process through which employees sign up for a flexible spending account (FSA) to manage their healthcare or dependent care expenses using pre-tax dollars.
Who is required to file flexible spending accounts enrollment?
Typically, employees who wish to participate in a flexible spending account must file an enrollment form provided by their employer during the open enrollment period.
How to fill out flexible spending accounts enrollment?
To fill out flexible spending accounts enrollment, employees should complete the designated enrollment form, providing necessary personal information, selecting the amount to contribute, and specifying the type of account (healthcare or dependent care).
What is the purpose of flexible spending accounts enrollment?
The purpose of flexible spending accounts enrollment is to allow employees to allocate pre-tax income into an FSA, thereby reducing their taxable income and saving on healthcare or dependent care costs.
What information must be reported on flexible spending accounts enrollment?
Information that must be reported includes the employee's personal details, the selected contribution amount, and the type of FSA being chosen.
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