EMPOWER
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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.

Enrollment is Easy with EMPOWER's Four-step Process!

1

Send Pre-enrollment educational materials to employees

2

Use EMPOWER’s enrollment forms or use your own. 

3

Send Enrollment to EMPOWER through our enrollment spreadsheet or EMPOWERConnect.

4

Send Welcome materials to employees to help them use their new benefits.

Flexible Spending Account (FSA)

Pre-enrollment Employee Education

Use the following resources to educate Employees on FSAs before enrollment.

Table of Contents

Flyers

English

Spanish

FSA Flyer (PDF)

PDF guide that details how an Health and Dependent Care FSAs work.

Dependent Care FSA Flyer (PDF)

PDF guide that provides information on Dependent Care FSAs.

Health FSA Flyer (PDF)

PDF guide that provides information on Health FSAs.

Limited Purpose FSA Flyer (PDF)

PDF guide that details how a Limited Purpose FSA works.
HSA Flyer (PDF)
PDF guide that explains HSAs to employees.
FSA, Limited Purpose FSA, and HSA Flyer (PDF)
One Page Guide that explains all three benefits to employees
FSA and HSA Flyer (PDF)
One Page Guide that explains the FSA and HSA to employees

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

FSA Information Page (Online)

Webpage that details how FSAs work.

Coming Soon

Videos

How an FSA Works (Video)

Video outlining how an FSA works.

How a Dependent Care FSA Works (Video)

Video outlining how a Dependent Care FSA works.

How to Pay for Braces (Video)

Video outlining how to pay for braces with an FSA.

Email Campaigns

FSA Email Campaign

Email campaign that you can send to employees for FSA education

Coming Soon

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

English

Spanish

Welcome Guide (PDF)

PDF guide that details the FSA Plan for new participants.

Coming Soon

Webpages

Welcome Guide (Online)

Webpage that details the FSA Plan for new participants.

Coming Soon

Health Savings Account (HSA)

Pre-enrollment Employee Education

Use the following resources to educate Employees on HSAs before enrollment.

Flyers

English

Spanish

HSA Flyer (PDF)

PDF guide that explains HSAs to employees.

Webpages

HSA Information Page (Online)

Webpage that details how HSAs work.

Coming Soon

Videos

HSA Benefits (Video)

Learn the advantages of enrolling in an HSA.

How to Pay for Braces with an HSA (Video)

Learn how to pay for braces with an HSA.

Email Campaigns

HSA Email Campaign

Email campaign that you can send to employees for HSA education

Coming Soon

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

HSA Enrollment Form (PDF)

This is an enrollment form that you may distribute to your employees.

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 HSAs.

Flyers

English

Spanish

Welcome Guide (PDF)

PDF guide that details the HSA Plan for new participants.

Coming Soon

Webpages

Welcome Guide (Online)

Webpage that details the HSA Plan for new participants.

Coming Soon

Health Reimbursement Arrangement (HRA)

Pre-enrollment Employee Education

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.

Flyers

Traditional HRA Flyer (PDF)

PDF guide that explains HRAs to employees.

HRA 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.

ICHRA Flyer (PDF)

PDF guide that explains ICHRAs to employees.

QSEHRA Notice

Employers are required to send a notice to employees 90 days prior to the start of the QSEHRA Plan Year.
Ask your Account Manager for this notice.

Videos

HRA Benefits (Video)

Learn the advantages of enrolling in an HRA.

Enrollment Forms

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.

Post-enrollment Employee Education

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.

Coming Soon

Webpages

Welcome Guide (Online)

Webpage that details the HRA Plan for new participants.

Coming Soon

EMPOWER Participant
Mobile App Download

If you have an FSA, HRA, or HSA with EMPOWER, we encourage you to
download the Mobile App to manage your benefits on the go!
Apple iOS
Google Android

Download Forms

Click one of the links below to view the available forms.

I am a Participant
Click the above link if you are a participant who has an FSA, HSA, or HRA with EMPOWER.
I am an Employer
Click the above link if you are an Employer or Consultant.