Flexible Spending Account - Ceridian
Ceridian Website

New Enrollment Packet – This is an account in which you can elect to have money taken out of your paycheck on a pre-tax basis. You can enroll as a new employee within 30 days from your start date. After that period, you would need to wait until open enrollment each December for the following year.

Within this plan, you have 2 options. You can choose either one or both.

• Medical, dental & vision reimbursements – You can elect to have up to $5,000/couple ($2,500/single) annually taken out of your check on a pre-tax basis for health care expenses that are not covered by insurance. You can submit your out-of-pocket expenses to Ceridian for reimbursement.
• Dependent care reimbursements This works the same as the health care account, but is for dependent care expenses.

*Please Note: The amount you are electing is for the current calendar year (Jan.-Dec.)

The benefit of the plan is that you save money on income taxes. The medical and dependent care expense accounts do require careful planning, as any unused money in the account at the end of the year is forfeited. See the Ceridian enrollment packet for more information on the plan and help in determining how much to put into the account.

Each year new forms need to be submitted:

• Ceridian FSA Enrollment Form
• Ceridian BCBS Automatic Claim Submission Form(optional)

If you are enrolled in the plan, links to the necessary forms are below:

• Ceridian Automatic Claim Submission Form
• Ceridian Direct Deposit Form
• Ceridian Election or Change Request Form
• Ceridian Leave of Absence Form
• Ceridian Health Reimbursement Form
• Ceridian Dependent Care Reimbursement Form
• Ceridian Health Expense Table
• Ceridian Online Account Information

For more information re: eligible Flex expenses, please contact IRS - Complex Issues Department, 800.829.1040

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