Dependent Care FSA

This benefit allows you to set aside pre-tax dollars from your
paycheck to pay for eligible dependent care expenses.
UNI FSA Benefits

List of FSA Benefits

Complete List of Benefits

Frequently Asked Questions: Click Here

Forms and Resources
FSA Reimbursement Request Form (PDF)
FSA Change Form (PDF)
Direct Deposit Reimbursement Form
Account Balances (PIN is provided by ASIFlex on the confirmation letter, see example)

Quick Tips
You will not receive a refund if you do not use all of your contributions during the plan year.

You may only change your election amount when you have a family status change.

Election changes must be made within 30 days of a family status change.

You must re-enroll each year during the open enrollment period.

The maximum amount is $5,000.00 per calendar year.

Eligible expenses are expenses incurred between January 1 through March 15 of the following year, or prior to your termination of employment.

Funds in the dependent care accounts are only available when they are deposited into your account.


Description of Dependent Care FSA

The Dependent Care Benefit Plan allows you to set aside dollars each year from your paycheck to pay for qualified dependent care expenses. These dollars are deducted from your wages before any income or social security taxes are paid. By using this tax savings plan, you will not only notice an increase in your take home pay, you will also have access to a reimbursement account throughout the year to pay your qualified expenses.

If you decide to enroll in the Dependent Care Flexible Spending Account, you must determine your dependent care expenses for the year. If you do not use all your contribution amount during the plan year (January 1 through March 15 of the following year), federal regulations require that remaining funds may not be refunded to the individual employees.

Once you have made your Flexible Spending Account election for the plan year, you may not change your election except within 30 days of a family status change. The IRS specifically defines a family status change as:

  • marriage,
  • divorce or legal separation,
  • death of your spouse or dependent,
  • birth or adoption of a child,
  • change in child custody, or
  • change in you or your spouse's employment status.


Participation in the spending accounts does not carry forward from year to year. You must re-enroll each year during the open enrollment period. Information about FSA open enrollment is sent to each employee in October. New enrollments are effective January 1st.

To enroll, or to make a modification, due to a family status change, send an email to requesting the appropriate forms. Then return the completed form(s) to Human Resource Services Office, 027 Gilchrist, 0034.

ASIFlex Mobile App

Flexible spending account participants now have the opportunity to use their smartphone/tablet to review their FSA account and file claims. ASIFlex's mobile app allows participants to submit a claim using your device’s camera. No more scanning, copying or mailing claim forms!

The free app is available on the App Store for Apple devices and the Google Play for Android devices.

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Date Updated: January 29, 2014