Requesting Mid-Year Changes in Health Care or Dependent Care FSA Elections

You may increase your contributions or decrease your contributions mid-year when one of the events listed below occurs for you, your spouse or your eligible dependent. The requested change in contribution must be consistent with your qualifying change of status.

The categories of change of status are:

1. A change in the your legal marital status
2. A change in the number of your dependents
3. Termination or commencement of employment by you, your spouse or your dependent
4. Change in work schedule for you, your spouse or your dependent
5. An unmarried dependent satisfies or ceases to satisfy the dependent eligibility requirements for a particular benefit
6. A change in eligibility for medical dental, or vision plan for you, your spouse, or your dependent
7. A change in the place of work or residence for you, your spouse or your dependent
8. Taking an unpaid leave of absence by either you or your spouse.

Additionally, you may increase or decrease your contributions to a Dependent Care FSA when you experience a significant change in the cost of your dependent care (e.g. unexpected increase in price.)

If one of the above events occurs, and you desire to make consistent changes to your benefit elections, you must inform the FSA Administrator of your new election within 60 days of the occurrence. All changes are made prospectively from the date that the FSA Administrator receives a properly completed and signed Benefit Election Form (BEF). Failure to submit your request within 60 days will result in your request being denied regardless of the reason.