Enrollment Resources for Flexible Spending Accounts (FSA)
This page shows enrollment resources for your FSA. If you wish to view all resources for your Plan, please click below.
Enrollment is Easy with EMPOWER's Four-step Process!
Send Pre-enrollment educational materials to employees
2
Use EMPOWER’s enrollment forms or use your own.
Send Enrollment to EMPOWER through our enrollment spreadsheet or EMPOWERConnect.
Send Welcome materials to employees to help them use their new benefits.
Table of Contents
Pre-enrollment Employee Education
Use the following resources to educate Employees on FSAs before enrollment.
Flyers
English
Spanish
FSA Flyer (PDF)
Dependent Care FSA Flyer (PDF)
Health FSA Flyer (PDF)
Limited Purpose FSA Flyer (PDF)
FSA Plan Fact Sheet (PDF)
A single page handout that contains specific details about your Plan.
Your Account Manager will email this to you before open enrollment starts.
Webpages
Videos
Email Campaigns
Enrollment Forms
EMPOWER accepts enrollment via our enrollment spreadsheet or EMPOWERConnect. We have provided the following enrollment forms if you would like to distribute and collect from your Employees.
English
Spanish
FSA Enrollment Form (PDF)
This is an enrollment form that you may distribute to your employees. This includes Health and Dependent Care FSAs.
FSA Enrollment Form with Limited Purpose FSA (PDF)
This is an enrollment form that you may distribute to your employees. Use this form if you offer a Limited Purpose FSA and FSA.
Enrollment Spreadsheet
EMPOWER accepts enrollment through EMPOWERConnect or the below enrollment spreadsheet. Please click the link below for instructions on how to submit the enrollment spreadsheet. Note that this enrollment spreadsheet will work for all EMPOWER benefits.
Enrollment Spreadsheet
This link contains instructions on how to submit enrollments to EMPOWER. The instructions include a link to download the spreadsheet template.
Post-enrollment Employee Education
The following resources provide information to new participants regarding how to use their FSAs.
Flyers
Welcome Guide (PDF)
PDF guide that details the FSA Plan for new participants.
Coming Soon
