GB-02 2023 Flexible Spending Arrangement Enrollment Form

The plan member must complete this form each year during annual enrollment to enroll into a Flexible Spending Arrangement (FSA). New hires have 30-days in which to decide to enroll in a FSA and complete this form.

Optum Financial FSA Claim Form (Effective June1, 2022)

Optum Financial Dependant Care Claim Form (Effective June1, 2022)

Optum Financial FSA FAQs (Effective June1, 2022)

Optum Financial FSA Eligible Expense List (Effective June1, 2022)

Optum Financial Dependent Care FSA – How it Works (Effective June1, 2022)