Office of Human Resources
Flexible Spending Accounts
Flexible Spending Accounts (FSAs) are part of an IRS regulated, employer-sponsored benefit plan that allows participants to voluntarily contribute part of their compensation into tax-free benefits. Contributions made through FSAs are normally free of federal, state and Social Security taxes. The Healthcare Flexible Spending Account allows for certain out-of-pocket healthcare expenses to be paid for on a pre-tax basis. Participant contributions are payroll deducted and placed in a special account for reimbursements to be issued as claims are incurred.
- Flexible Spending Account Agreement Form
- Answers to FSA Frequently Asked Questions
- Aetna Direct Deposit Authorization Form
- Aetna FSA Claim Form
- Aetna Limited Purpose FSA Claim Form
- EBS Direct Deposit Authorization Form
- EBS Health Care FSA Claim Form
- EBS Limited Purpose FSA Claim Form
- EBS Dependent Care FSA Reimbursement Form
- Refer to IRS Publication 502 for information regarding medical, dental and health related expenses eligible for reimbursement through a Health Care FSA
Note: Individuals represented by collective bargaining agreements receive benefits in accordance with those agreements.