Use the Medical FSA application to view an existing record or add a new record.
The Medical FSA screen displays the current and new annual contribution and pay frequency amount, allowing you to choose a new election amount during the Benefits Enrollment or Life Events/New Hires process.
This field displays the annual contribution election.
This field displays the elected per pay period deduction amount.
Enter a new annual contribution amount. The text below the table states the maximum annual amount that you can contribute: "You may enter a New Annual Contribution amount up to <maximum amount displays here>."
Enter the pay period deduction amount. If you do not wish to participate in the Medical FSA plan, you must enter "0.00" in the New <Frequency> field.
Click FSA Worksheet to estimate, by category, the amounts for unreimbursed medical expenses you plan to set aside for the new calendar year.
Select this button to return to the splash screen.
Select this button to return to the previous page.
Select this button to update the database with a placeholder and proceed to the next screen/page. Then you can revisit the Life Events/New Hires process at a later time to complete the pages that have a "Come Back Later" status.
Select this button to leave your benefit election(s) "as is" and proceed to the next screen/page.
Select this button to update the database with your changes and proceed to the next screen/page.