HCSA and DCAP enrollment is on a calendar, not fiscal, year basis (January 1 -

December 31).   This program has an open enrollment period, meaning participants must re-enroll each year.

Existing Enrollees:

  1. During open enrollment, current enrollees should re-enroll online on the FSA carrier’s website (see the GIC’s forms section for links). The employee must print, sign and date the online confirmation page and give it to the payroll office.
  2. Enter the HCSA/DCAP and pre-tax fee amounts into your payroll system.
  3. File a copy of the online confirmation page in the employee’s personnel file. Do not send forms to the GIC or the FSA carrier.

New Enrollees:

  1. Instruct the employee to complete, sign and date the HCSA/DCAP GIC Flexible Benefit Plan Enrollment Form. See the Direct Deposit Instructions on form.
  2. Complete the Payroll Coordinator section of the form. Indicate your Department ID# (999XXXX).
  3. Send a copy of the completed and signed form to the HCSA/DCAP carrier by mail or fax. Note: Failure to send a form to the HCSA/DCAP carrier will result in an employee not receiving reimbursement for an eligible HCSA and/or DCAP expense.
  4. Enter the HCSA/DCAP and pre-tax fee amounts into your payroll system.
  5. File a copy of the application in the employee’s personnel file. Do not send forms to the GIC.

This information provided by the Group Insurance Commission .