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Flexible Spending Accounts

The University offers a flexible spending reimbursement account (known as FSA or FLEX) for certain eligible medical and dependent care expenses.  This plan offers tax savings opportunities to eligible employees.

FSA open enrollment is only once per year.  If you miss the annual deadline, you will need to wait until next year to participate, unless you have a change in family status.  Watch your employee email account for notification of the annual enrollment period and instructions.

FSA forms (PDF)

Flex_Enrollment_Election_Form.pdfFSA Enrollment Form (Account Election)FSA Enrollment Form (Account Election)/www.udmercy.edu/hr/benefits/flex/pdf/Flex_Enrollment_Election_Form.pdf56996FSA_Brochure.pdfFSA BrochureFSA Brochure/www.udmercy.edu/hr/benefits/flex/pdf/FSA_Brochure.pdf837046My_FLEX_Online_Instructions.pdfMy Flex Online InstructionsMy Flex Online Instructions/www.udmercy.edu/hr/benefits/flex/pdf/My_FLEX_Online_Instructions.pdf0Take_Care_Flex_Card_Instructions.pdfTake Care Flex Card InstructionsTake Care Flex Card Instructions/www.udmercy.edu/hr/benefits/flex/pdf/Take_Care_Flex_Card_Instructions.pdf117697FSA_Debit_Card_FAQ.pdfFSA Debit Card FAQFSA Debit Card FAQ/www.udmercy.edu/hr/benefits/flex/pdf/FSA_Debit_Card_FAQ.pdf0My_FLEX_Mobile_Instructions.pdfMy Flex Mobile InstructionsMy Flex Mobile Instructions/www.udmercy.edu/hr/benefits/flex/pdf/My_FLEX_Mobile_Instructions.pdf300746EBC_Direct_Deposit_Form.pdfDirect Deposit FormDirect Deposit FormDirect Deposit FormDirect Deposit Form/www.udmercy.edu/hr/benefits/flex/pdf/EBC_Direct_Deposit_Form.pdf0EBC_Summary_Plan_Description.pdfFSA Summary Plan DescriptionFSA Summary Plan Description/www.udmercy.edu/hr/benefits/flex/pdf/EBC_Summary_Plan_Description.pdf72527FSA_Qualified_Expenses.pdfQualified Medical ExpensesQualified Medical Expenses/www.udmercy.edu/hr/benefits/flex/pdf/FSA_Qualified_Expenses.pdf51116EBC_Qualified_Daycare_Expenses_2011.pdfQualified Daycare ExpensesQualified Daycare Expenses/www.udmercy.edu/hr/benefits/flex/pdf/EBC_Qualified_Daycare_Expenses_2011.pdf30850EBC_Qualified_Elder_Care_Expenses_2011.pdfQualified Elder Care ExpensesQualified Elder Care Expenses/www.udmercy.edu/hr/benefits/flex/pdf/EBC_Qualified_Elder_Care_Expenses_2011.pdf107667EBC_FLEX_Medical_Claim_Form.pdfMedical Claim FormMedical Claim Form/www.udmercy.edu/hr/benefits/flex/pdf/EBC_FLEX_Medical_Claim_Form.pdf38701EBC_Dependent_Care_Claim_Form.pdfDependent Care Claim FormDependent Care Claim Form/www.udmercy.edu/hr/benefits/flex/pdf/EBC_Dependent_Care_Claim_Form.pdf303251/www.udmercy.edu/hr/benefits/flex/pdf/formsforms