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    Flexible Spending Account (FSA)

    If you have any FSA related questions, please contact Joan Zaw and Debbie Poon. We recommend for all employees to visit the New York City Office of Labor Relations’ webpage for the most up-to-date information and document submission.

    Forms and Resources

    • NYC Flexible Spending Accounts (FSA) Program Summary
    • 2023 Flexible Spending Accounts Program Brochure
    • 2023 FSA Enrollment/Change Form
    • 2023 MSC Health Benefits Buy-Out Waiver Enrollment/Change Form
    • 2023 MSC Premium Conversion Enrollment/Change Form

    FSA Claims Forms

    Please direct all inquiries/correspondence and claims as follows:
    1) Inquiries and questions can be sent via email to the Program.
    2) Forms/documents can be submitted electronically to: https://nyc-fsa.leapfile.net

    Please note that, once the FSA office receives and processes the HCFSA/DeCAP enrollment forms, the participants will receive a confirmation letter.

    Important:  If the participant does not experience FSA payroll deductions in January 2023, the participants should notify the FSA office immediately. Please note that, for CUNY Baruch employees, the payroll deductions will begin in the second paycheck in January 2023.

    Plan Year 2023

    • 2023 DeCAP Claims Form
    • 2023 HCFSA Claims Form

    For additional information please visit the following links:

    • Flexible Spending Accounts (FSA) – Office of Labor Relations (OLR) Homepage
    • Flexible Spending Accounts (FSA) Program Guides, Brochures & Forms – Office of Labor Relations (OLR) Homepage
    Updates

    Plan Year 2023 Annual Open Enrollment Period

    The Annual Open Enrollment Period for Plan Year 2023 will be October 17, 2022 to November 18, 2022. The Flexible Spending Accounts (FSA) Program Enrollment/Change Form will be available in early October. Please check back periodically for program materials and updates.

    FSA Open Enrollment Dates: Oct. 17 – Nov. 18

    Open Enrollment: Flexible Spending Accounts (FSA) Program:

    Enrollment in the HCFSA and DeCAP is not automatic and your previous year’s election will not rollover. New and current participants must enroll/re-enroll each year during the annual open enrollment period.

    Enrollment Dates: October 17, 2022- November 18, 2022

    • Flexible Spending Accounts Program Brochure
    • FSA Enrollment/Change Form

    How to Submit Enrollment/Change Forms:

    Employees who wish to participate in the HCFSA and/or DeCAP program for Plan Year 2022 can download the applicable form(s) from the FSA website and must submit the completed forms(s) electronically to the following secure site: https://nyc-fsa.leapfile.net

    Please DO NOT mail any forms via UPS or FedEx packages to the FSA Administrative Office. However, employees can submit forms via regular mail to:

    Attn: OLR, Flexible Spending Accounts: 2022
    22 Cortlandt Street, 28th Floor
    New York, NY 10007

    Current Participants in the HCFSA Program and/or DeCAP

    Employees currently enrolled in the HCFSA and/or DeCAP Program will automatically receive a letter sent to their address on file in the beginning of October 2021. They can enroll in Plan Year 2022 for HCFSA and/or DeCAP by completing the bottom portion of the letter and returning it to the above secure site, as long as there are no changes to the participant’s information, except for the indicated goal amount. If there are any changes to the participant’s information, the employee must complete a Plan Year 2022 Enrollment/Change Form.


    Office of Human Resources One Bernard Baruch Way, Box D-0202 (New York, NY 10010) 646-660-6590
    Human.Resources@baruch.cuny.edu
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