Dependent Care (DepCare) Flexible Spending Account
The DepCare program allows you to pay for certain dependent care expenses on a pretax, salary reduction basis. When you enroll, you designate an amount from your paycheck, thus opens your DepCare account. This amount is deducted before Federal, State and Social Security taxes are taken out, thus lowering your taxable earnings.- Dependent Care Summary Plan Description - Complete details and explanation of this program rules and how the plan works: when and how to enroll. Also, whether possible to change contribution amount or cancel program.
- Salary Reduction Agreement (UPay 717): the UC form to enroll, change or cancel plan. (New employees should enroll on-line when they sign in and enroll for benefits on the At Your Service website.)
Health Flexible Spending Account
This program allows you to pay for eligible out-of-pocket health care expenses on a pretax, salary reduction basis. Some examples of eligible expenses include health plan deductibles, co- pays and some eligible over the counter medication, etc..- Health Care Reimbursement Account Summary Plan Description - Complete details and explanation of this program rules and how the plan works: when and how to enroll. Also, whether possible to change contribution amount or cancel program.
- Salary Reduction Agreement (UPay 717): the UC form to enroll, change or cancel plan pending qualifying events. (New employees should enroll on-line when they sign in and enroll for benefits on the At Your Service website.)
2008 SHPS HCRA Spending Card - Ineligible Expenses
You may be required to submit receipts for some purchase made with your VISA Spending Card. As of 1/1/2009, the SHPS spending card is inactive. See "Transition from SHPS to CONEXIS" link below.
CONEXIS is new FSA vendor in 2009
Transition from SHPS to CONEXIS
2008 HCRA members who are enrolled in the 2009 CONEXIS Health FSA must decide which plan to use during "grace period".
As of 1/1/2009, the SHPS spending card is inactive. You must submit paper claim forms with the itemized receipts to use the remaining
dollars in your 2008 SHPS account. See "Transition from SHPS to CONEXIS" link above.
CONEXIS Customer Service: 1-800-482-4120 (Monday - Friday 5 am to 5 pm PST).
CONEXIS Forms and Resources
- Dependent Care FSA Claim Form
- Health FSA Claim Form
- Request for Second Debit Card
- Automatic Deposit Form for reimbursements
- Participating Retail Merchants
Questions?
Contact us