Get the free TexFlex Enrollment/Change Form - collin

This form is used by employees of the Employees Retirement System of Texas to enroll in or change their Flex Spending accounts due to qualifying life events.

How to fill out texflex enrollmentchange form

How to fill out TexFlex Enrollment/Change Form

1. Obtain a copy of the TexFlex Enrollment/Change Form from the official website or HR department.
2. Fill out personal information such as name, address, and employee ID.
3. Select the type of account you wish to enroll in or change (e.g., medical, dependent care).
4. Indicate the desired contribution amounts for each account.
5. Provide any necessary supporting documentation, if required.
6. Review all information for accuracy and completeness.
7. Sign and date the form.
8. Submit the completed form to the designated HR representative or through the specified submission method.

Who needs TexFlex Enrollment/Change Form?

1. Employees who want to enroll in or make changes to their TexFlex flexible spending accounts.
2. Employees seeking to adjust their contribution amounts during the open enrollment period.
3. New employees who are eligible for TexFlex benefits.

People Also Ask about

What are eligible expenses for Flexfacts?

An eligible expense is any healthcare or dependent care expense approved by the IRS for reimbursement through the plan.

What can I use my TexFlex card for?

Purchase eligible services or items and submit your claims, or use your TexFlex debit card to pay directly from your health care or limited-purpose FSA. You can file a claim for dependent care expenses only after the care has been provided, even if you pay for the care in advance.

What are eligible expenses for Payflex Limited FSA?

Works great with a health savings account (HSA), as it can help save your HSA dollars for future expenses. Eligible expenses may include: 4 Dental and orthodontia care, like fillings, X-rays and braces. 4 Vision care, including eyeglasses, contact lenses and LASIK laser eye surgery.

What are eligible expenses for Tex Flex?

Examples of eligible expenses include after-school care, nursery school, preschool, summer day camp and adult daycare. Eligible children must be under age 13. Eligible adults (or children age 13 and older) must be unable to care for themselves.

What is an enrollment change form?

Enrollment/Change Form means an agreement pursuant to which an Employee may elect to enroll in the Plan, to authorize a new level of payroll deductions, or to stop payroll deductions and withdraw from an Offering Period.

For pdfFiller’s FAQs

What is TexFlex Enrollment/Change Form?

The TexFlex Enrollment/Change Form is a document used by eligible employees in Texas to enroll in or make changes to their flexible spending accounts (FSAs) offered through the TexFlex program.

Who is required to file TexFlex Enrollment/Change Form?

Employees who wish to enroll in or modify their participation in the TexFlex program are required to file the TexFlex Enrollment/Change Form.

How to fill out TexFlex Enrollment/Change Form?

To fill out the TexFlex Enrollment/Change Form, employees should accurately provide their personal information, select the type of account they wish to enroll in, specify the desired contribution amounts, and sign the form before submission.

What is the purpose of TexFlex Enrollment/Change Form?

The purpose of the TexFlex Enrollment/Change Form is to facilitate the enrollment or modification of an employee's contributions to flexible spending accounts, allowing them to manage their pre-tax dollars for healthcare or dependent care expenses.

What information must be reported on TexFlex Enrollment/Change Form?

The TexFlex Enrollment/Change Form must include the employee's name, ID number, contact information, selected account type, contribution amount, and necessary signatures to validate the form.