Enroll in the FSA and/or DCAP

State of Washington employees can enroll in the  2017 FSA and/or DCAP through the following methods and guidelines:

PEBB eligible employees can enroll through a paper enrollment if one of the following conditions applies.

  • When you become eligible for PEBB benefits. You must enroll within 31 days of becoming eligible for PEBB benefits. If you are unsure of your PEBB benefits eligibility date, please consult your local benefits office.
  • You may enroll during the 2017 plan year if you or an eligible family member has a qualified change in status event that creates a special open enrollment. You must submit your paper enrollment form to your benefits office within 60 days after the date of the qualifying event.

University of Washington Employees: All benefits enrollments for UW employees are managed solely through Workday.

enroll in 2017 via paper

Download a 2017 enrollment form and mail, email or fax it in.

get the form

enroll in 2018 via paper

Download a 2018 enrollment form and mail, email or fax it in.

get the form