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FLEXIBLE SPENDING ACCOUNT AND DEPENDENT CARE

 

FLEXIBLE SPENDING ACCOUNT AND DEPENDENT CARE

 

NOTE: Due to IRS regulations, Human Resources now requires enrollment forms be submitted annually for Flex Spending Account and/or Dependent Care Accounts.  Thank you in advance.

  • Please DO NOT send any enrollment forms to individuals within Human Resources

The Enrollment form should be filled out and  submitted to: openenrollment@pendercountync.gov on or before 10/11/2019.

 

2019 Flexible Benefit Account Enrollment Form

 

PLEASE BEWARE:

***** ANY ENROLLMENT FORMS NOT RECEIVED BY END OF BUSINESS ON OCTOBER 11, 2019 WILL CONSTITUTE A WAIVE OF COVERAGE REGARDLESS OF YOUR SELECTION ON THE QUESTIONNAIRE****

 

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