FSA (Medical and Dependent) Enrollment Form
2023 Max Limit Contributions:
Medical - $3,050.00
Dependent Care - $5,000.00
*FSA works as a "use it or lose it" account, meaning any funds that are not spent by the end of the calendar year will be lost.
*Anyone can participate in the FSA plan, even if not covered under a school-sponsored insurance plan.
*If you have both an HSA and FSA Medical account, you may only use your FSA account for Dental and Vision.
*Contribuatinos are made tax-free!