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Flexible Spending Account​

Healthcare FSA - Employee Funded

A healthcare FSA is an account funded by you to pay for healthcare services such as prescription co-payments, deductibles and doctor's office co-payments with pre-tax money. The amount of pre-tax money you set aside through payroll deduction is loaded on your HumanaAccessSM Visa® Debit Card, which you use to pay for covered expenses.

Download the Summary Plan Description

Dependent Care Flexible Spending Account – Employee Funded (Child or Adult Day Care)

A dependent care FSA allows you to use pre-tax money to pay for dependent care expenses such as a day care or after-school program for dependents up to age 13, or for adult day care.

Download the Summary Plan Description

FSA Forms and Resources

Complete the FSA enrollment/change form

Download a list of sample expenses

HRA/FSA reimbursement form


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