Flexible Spending Accounts (FSA)
Health FSA Information
- What is a Health Flexible Spending Account (FSA)?
- What if I don’t use the whole amount that I elected to contribute to my FSA?
- How do I submit a claim for reimbursement?
- An employee of Forest Grove School District can contribute no more than $2,400 pre-tax dollars per plan year toward a Health Flexible Spending Account. An employee must re-enroll each plan year.
- Download enrollment form
- Plan year = 10/1/17 - 9/30/18
- Division = N/A
- Number of pay periods = 12
- Sign and return to Jennifer Brewer at the District Office by 9/15/17
- Download Direct Deposit Form
- Attach a voided check (not a deposit slip)
- Please return the Direct Deposit form to Jennifer Brewer at the District Office by 9/15/17
- Allegiance Website: www.allegianceflexadvantage.com
Dependent Care FSA Information
- What is a Dependent Care Flexible Spending Account (FSA)?
- What if I don’t use the whole amount that I elected to contribute to my FSA?
- How do I submit a claim for reimbursement?
- An employee of Forest Grove School District can contribute no more than $5,000 pre-tax dollars per plan year toward a Dependent Care Flexible Spending Account.
- An employee must re-enroll each plan year.
- Download enrollment form and sign it
- Plan year = 10/1/17 - 9/30/18
- Division = N/A
- Number of pay periods = 12
- Please return the enrollment form to Jennifer Brewer at the District Office by 9/15/17
- Download Direct Deposit Form
- Attach a voided check (not a deposit slip)
- Please return the Direct Deposit form to Jennifer Brewer at the District Office by 9/15/17
- Allegiance Website: www.allegianceflexadvantage.com
Reimbursement for eligible expenses
- How do I submit a claim for reimbursement?
- Allegiance Website: www.allegianceflexadvantage.com
- Customer Service: 1-866-339-4310