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 Resources Only:
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.
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)
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
English
Spanish
Welcome Guide (PDF)
PDF guide that details the FSA Plan for new participants.
Coming Soon
Webpages
Health Savings Account (HSA)
Pre-enrollment Employee Education
Use the following resources to educate Employees on HSAs before enrollment.
Flyers
English
Spanish
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
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
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)
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.
QSEHRA Notice
Videos
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
