2015 DCAP Enrollment form doc format of 2015FSA_enrollform.doc
for new participants - Enroll in DCAP benefits as a 2015 new hire.

DCAP Claim Form doc format of GIC_FSA_claimform2015.doc
: Use this form to submit dependent care-related claims for reimbursement.

Flexible Spending Account Status Change form doc format of 2015FSA_enroll_changeform.doc
– use this form to increase or decrease your contribution to, or terminate your election in Flexible Spending Account within 30 days of a qualifying event during the plan year. You must submit this form with supporting documentation within 30 days of the qualifying event: change in legal marital status; change in number of dependents; change in employment status; change in work schedule that affects your eligibility for the program; change in dependent’s FSA eligibility, or a judgment decree pertaining to your spouse or child.

2015 DCAP Participants Re-Enroll in benefits for 2016 on FSA website during the Fall 2015 Open Enrollment period. 

Open Enrollment Re-enrollment Instructions (not yet available).  2015 participants will re-enroll for 2016; these instructions will explain the online re-enrollment steps.


HCSA Questions?

2015 Calendar Year Flexible Spending Account handbook doc format of 2015_FSAparticipant_handbook.doc
Contact ASIFlex; 1-800-659-3035

This information provided by the Group Insurance Commission .