Advanced Flex Plan Administration with the Human Touch
Enrollment Resources for all Benefits
This page provides enrollment resources for all Benefits. Use this page as a quick guide to helpful tools to help you in the enrollment process.
This page shows enrollment resources for all benefits. If you wish to view only the resources for your Plan, or view all resources, click the appropriate button below.
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.
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.
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
HSA Enrollment Form (PDF)
This is an enrollment form that you may distribute to your employees.
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.
Although employees are typically automatically enrolled in an HRA when they enroll in the associated Group Health Plan, EMPOWER has provided materials below to educate employees.
Since employees do not typically enroll in HRAs, EMPOWER does not furnish forms. If you have a Plan that does allow employees to enroll and would like assistance, please contact EMPOWER.
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.
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.
Flyers
English
Spanish
HRA Plan Fact Sheet (PDF)
PDF Guide that explains the QSEHRA for participants.
Your Account Manager will email this to you before open enrollment starts.
QSEHRA Welcome Guide
A single page handout that contains specific details about your Plan.