Enroll in the FSA and/or DCAP

State of Washington employees can enroll in the 2019 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 2019 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 and evidence of the event that created the special open enrollment to your benefits office within 60 days after the date of the qualifying event.
  • You may enroll for the 2020 plan year between November 1, 2019 and November 30, 2019 if you are eligible for PEBB benefits

University of Washington Employees: Please do not submit paper enrollments, or enroll separately on this website. All benefits enrollments for UW employees are managed solely through Workday.

enroll in 2019 via paper

Download a 2019 enrollment form and mail, email or fax it in.

get the form

enroll in 2020 via paper

Download a 2019 enrollment form and mail, email or fax it in.

get the form

enroll in 2020 online

Register an account to submit your enrollment electronically.

get the form

Educational Materials

Register here to join one of our live Medical FSA & DCAP Plan Education Sessions https://attendee.gotowebinar.com/rt/4235333485509252355

Video: What is the Flexible Spending Account and Dependent Care Assistance Program and how does it work

Video: Pre-Tax Benefits Overview