Forms
Forms must be downloaded to your device in order for the fillable sections to work. Once completed, save to your device and then send the completed form to [email protected].
- Full-Time Healthcare Plan Enrollment Change Form
- Part-Time Healthcare Plan Enrollment Change Form
- To submit an Aetna Claim: Log into your Aetna member account to securely submit claims.
- Adding Domestic Partner to Your Health Benefits (.pdf)
- FSA Web Access Flyer (.pdf)
- Link to Your Flexible Benefit Administrators Account
- To submit a Dependent Daycare FSA Reimbursement Form and a Healthcare FSA Reimbursement Form: Log into your Flexible Benefit Administrators account to securely submit forms.
- FSA Online and Mobile Claims Submission Instructions (.pdf)
- Flexible Spending Account Direct Deposit Form (.pdf)
- Overview of FSA Plan (.pdf)
- Comprehensive FSA Guide (.pdf)
- FSA Eligible Expenses (.pdf)
- How to Use Your Benefits Card (.pdf)
- Flexible Benefits Administrator's Mobile Application (.pdf)
- Online Enrollment Instructions (.pdf)
- Retirement@Work Website (online enrollment and plan management system)
- Making Retirement Account Changes Guide (.pdf)
- Summary of Benefits Upon Separation of Employment (.pdf) (Full-Time Employees)
- Summary of Benefits Upon Separation of Employment (.pdf) (PT FIT Employees)
- Summary of Benefits Upon Separation of Employment (.pdf) (PT Student Housing)