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O COCHISE \'\'. COLLEGEBENEFITSCochise Combined TrustFLEXIBLE SPENDING ACCOUNT ENROLLMENT FORM Plan Year: 20232024 New ElectionElection ChangeEmployee NameSSNMailing AddressCity/State/ZIPBirth DateEffective
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How to fill out flexible spending account continuation

How to fill out flexible spending account continuation
01
Gather required documents, including your FSA card and receipts.
02
Obtain the FSA continuation form from your employer or plan administrator.
03
Fill out your personal information on the form, including your name, address, and employee ID.
04
Indicate the amount you wish to continue contributing to your flexible spending account.
05
Provide details about your eligible expenses for reimbursement.
06
Sign and date the form to confirm your request.
07
Submit the completed form to your employer or FSA administrator by the deadline.
Who needs flexible spending account continuation?
01
Employees who have incurred qualifying medical expenses.
02
Individuals who wish to continue utilizing their FSA benefits after leaving a job.
03
People who want to take advantage of tax savings on eligible healthcare costs.
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What is flexible spending account continuation?
Flexible spending account continuation refers to the process that allows employees to maintain access to their flexible spending account (FSA) benefits after a qualifying event, such as employment termination.
Who is required to file flexible spending account continuation?
Typically, employees who experience a qualifying event, such as leaving their job or experiencing a change in family status, are required to file for flexible spending account continuation.
How to fill out flexible spending account continuation?
To fill out flexible spending account continuation, individuals should complete the required forms provided by their employer or plan administrator, ensuring all personal and account information is accurately reported.
What is the purpose of flexible spending account continuation?
The purpose of flexible spending account continuation is to allow individuals to use the funds they have contributed to their FSA for eligible expenses, even after leaving their employer or experiencing other qualifying events.
What information must be reported on flexible spending account continuation?
Information that must be reported includes personal identification details, account balance, dates of qualifying events, and any eligible expenses that are being claimed.
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