|The Fringe Benefit Accounting and Compliance Team (FBAC) handles all the benefit-related accounting transactions for the University. This includes vendor payable and receivable transactions, reconciliation and remittance of benefit premiums collected from payroll, and benefit-related payroll adjustments. The FBAC team also manages the Iowa State University Fringe Benefit Pool.
This form is used to request a change in Health Care FSA or Dependent Care FSA. Return this completed, signed form to the University Benefits office within 30 days of a qualifying event (60 days for birth or adoption).
Questions regarding this form? Please reference the Unforeseeable Emergency FAQ Form (PDF).
A flexible spending account is an employee benefit that allows you to have deductions withheld from your paycheck on a pre-tax basis for eligible out-of-pocket health care and dependent care costs.