Benefits Change Connection

Begin or Change a Tax Saver Benefit (TSB) Account

A qualified change of status will allow you to make changes to a plan outside of Open Enrollment. Any changes must be made within 30 days from the date of the change in status.

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1. Complete the Change of Status form and return it to the campus Human Resources office. (This step is required by the IRS.)
2. Upon receipt of the Change of Status form, the campus Human Resources office will send you a personalized benefit enrollment form to change your plan or coverage, or you may arrange to pick it up.
3. Review the Tax Saver Benefit plan booklet and decide what changes you will make to your plan.

In the case of marriage, changes to an existing TSB plan election will create two election periods--one before and one after the marriage. Consult Nyhart (the plan administrator) with any questions about eligible expenses for the two periods.

4. Consult Nyhart or a tax advisor if you have questions about the tax consequences of a change.
5. Complete the Tax Saver Benefit section of the personalized enrollment form you receive and return it to the Human Resources office. You may need to bring supporting documentation as indicated on this form. (You only need to do this once.)
6. If desired, participants may authorize direct deposit of the reimbursed funds using the Direct Deposit Authorization/Termination form.
7. Participants may also choose the debit-type card option for purchases and track their account balances online. For details, visit the TSB Web page.

 

Forms and Publications

Change of Status form

Direct Deposit Authorization/Termination form

Dependent Care Flexible Spending Account Worksheet

Healthcare Flexible Spending Account Worksheet

Tax Saver Benefit plan booklet