FSA
&
DCA

Use the enrollment set up instructions to set up your elections for a Medical Flexible Spending Account and/or Dependent Care Flex Spending Account on the csONE site. The maximum election amount this year (2022-2023) for FSA is $2850 and $5,000 for Dependent care. Up to $570 of unused funds from your Medical Flex account will roll into the new fiscal year. New hires will have 30 days to decide to make an election once eligible for benefits.

FSA AND/OR DCA ENROLLMENT FORM - Turn the completed form into the HR department.

FSA Reimbursement Request Form (fillable)

Dependent Care Claim Form (fillable)

Authorization Agreement for Direct Deposit Form

csONE

csONE Employee Portal Set Up Instructions
csONE FSA/DCA Enrollment Set Up Instructions

Questions about these two benefit accounts should go to csONE at 603-227-2021 or Lisa Ouellette at louellette@csone.com