The Flexible Spending Account (FSA) program administered by Benesyst allows regular employees to pay for out-of-pocket health care, dependent care and personally paid health insurance premiums with pre-tax dollars. At enrollment, new participants designate the FSA election amount for the coming year. This annual amount is deducted from the employee’s paychecks in equal installments, on a pre-tax basis, from January through October, and credited to the employee’s FSA account(s). Requests for reimbursement of eligible expenses are submitted to and paid by a third party administrator. The employee does not pay income or social security taxes on FSA contributions.
Federal law prohibits any change in a FSA during the calendar year unless the participant or his or her dependent(s) experiences a qualifying “life event,” such as marriage, divorce or legal separation, birth, adoption or death of a dependent, or a change in the participant’s or the spouse’s employment status.
An annual FSA contribution election amount may be changed during the annual open enrollment period. If no changes are submitted during open enrollment, the participant’s current contribution level will continue in the next year.
Benesyst Reimbursement Forms
- Online Reimbursement Request
- Dependent Care Reimbursement Request Form (PDF)
- Health Care Reimbursement Request Form (PDF)
- Direct Deposit Authorization Form (PDF)
For further information, please contact: