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Employees & Retirees

City of Lincoln Park Flexible Spending Account (FSA)
Open Enrollment for Plan Year 2024

The Flexible Spending Plan Year is January 1, 2024, to December 31, 2024.

Additional information regarding the plan along with the enrollment form is available below, under FSA information. 

A minimum annual salary election of $500 is required to participate in the 2024 Medical Reimbursement FSA account. In addition, to be granted access to any rollover funds up to $550 from 2021, you must open a new Medical Reimbursement FSA account for the next calendar year with an effective date of January 1, 2024.

The Dependent Care Account is not subject to a rollover. A new account must be opened each calendar year to participate in the program.

An enrollment form is required to be completed EACH CALENDAR YEAR to participate in the Flexible Spending Account. The deadline to submit your completed enrollment form to the Human Resources Department is Friday, December 1, 2023, at 3 p.m.

Should you have questions regarding the Flexible Spending Account (FSA), please contact the Human Resources Department at ext. 1221 or 1222. You may also contact BASIC at 800-372-3539 and press 1.

Thank you.
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Employees 12 documents
CAT:1331
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document Header 2024 BCBS Simply Blue 500 Benefit at a Glance
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document Header 2024 BCBS Simply Blue 500 Summary of Benefits and Coverage
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document Header 2024 Delta Dental Benefits at a Glance
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document Header 2024 Enrollment/Waiver of Coverage Form
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document Header 2024-2025 Notice of Creditable Coverage
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document Header BCBS Simply Blue 2000 HSA Benefit at a Glance
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document Header Employee Change Form
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document Header Withholding Form - Federal
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document Header Withholding Form - Michigan
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Flexible Spending Account 2 documents

sub:1338
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document Header Basic FSA Guide
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document Header FSA Enrollment Form 2024
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Retirees 71 documents
CAT:1344

2024 Medicare Eligible 11 documents

sub:2051
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document Header 2024 Medicare Eligible Selection Form
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document Header 2024 Medicare Eligible Selection Form ENHANCED
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document Header 2024 Option 1 BAAG
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document Header 2024 Option 1 Enrollment Form
file:2056
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document Header 2024 Option 2 BAAG
file:2053
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document Header 2024 Option 2 Enrollment Form
file:2057
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document Header 2024 Option 3 BAAG
file:2054
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document Header 2024 Option 3 Enrollment Form
file:2058
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document Header 2024 Option 4 BCN BAAG
file:2055
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document Header 2024 Option 4 Enrollment Form
file:2059
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document Header CMS Notice
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2023 Medicare Eligible 16 documents

sub:1724
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document Header 2023 BCN Advantage Formulary
file:1968
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document Header 2023 MA Option 1 BAAGS
file:1970
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document Header 2023 MA Option 1 Enrollment Form
file:1969
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document Header 2023 MA Option 2 BAAGS
file:1972
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document Header 2023 MA Option 2 Enrollment Form
file:1971
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document Header 2023 MA Option 3 BAAGS
file:1974
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document Header 2023 MA Option 3 Enrollment Form
file:1973
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document Header 2023 MA Option 4 BCN BAAGS
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document Header 2023 MA Option 4 Enrollment Form
file:1975
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document Header 2023 Medicare Plus Comprehensive Formulary
file:1965
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document Header 2023 Medicare Plus Enhanced Comprehensive Formulary
file:1966
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document Header BCN Pre Enrollment Checklist
file:1732
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document Header BCN Service Area
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document Header Benefits at a Glance BCN
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document Header Medicare Eligible Selection Form 2023
file:1790
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document Header Medicare Eligible Selection Form ENHANCED 2023
file:1791

Non-Medicare Eligible 23 documents

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document Header Acceptance Agreement & Release Form
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document Header Annual Notices 2023
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document Header BCN Authorization Process
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document Header Blue Care Network (BCN) HMO Benefits at a Glance
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document Header Blue Care Network (BCN) HMO Summary of Benefits and Coverage
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document Header Blue Care Network (BCN) Referrals
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document Header Blue Care Network (BCN) Understanding the Referral Process
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document Header Blue Care Network Rx Benefits at a Glance
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document Header CMS Notice About Your RX Drug Coverage and Medicaid 2021
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document Header Health Care Reform FAQ Getting Lower Costs on Coverage
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document Header Health Care Reform: Enrolling in Health Insurance Marketplaces
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document Header Medicare Part D Notice 2023
file:2031
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document Header Non Medicare Eligible Enrollment Form for Enhanced Benefits
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document Header Non-Medicare Eligible Retiree Coverage Selection Form July 2022
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document Header Open Enrollment for Enhanced Non-Medicare Eligible Retirees
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document Header Open Enrollment for Non-Medicare Eligible Retirees
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document Header Premium Assistance Under Medicaid and CHIP
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document Header Simply Blue 1500 Benefits at a Glance
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document Header Simply Blue 500 Benefits at a Glance
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document Header Simply Blue 500 Summary of Benefits and Coverage
file:1828