Flexible Spending Accounts

A Flexible Spending Account (FSA) is a tax-favored program offered by the City that allows employees to pay for eligible out-of-pocket health care and dependent care expenses with pre-tax dollars. The City offers three FSA accounts: Unreimbursed Medical (URM), Limited Expense Unreimbursed Medical (LEX URM), and Dependent Care Assistance Program (DCAP). Navia administers the FSA program. You may now submit your claims to Navia using their online portal.

Benefit eligible expenses for URM and LEX URM

Unreimbursed Medical (URM)

  1. Reimbursement Form
  2. URM Enrollment Form 2022

Limited Expense Unreimbursed Medical Program

  1. LEX URM Enrollment Form 2022
  2. Reimbursement Form

Dependent Care Assistance Program (DCAP)

  1. DCAP Enrollment form 2022
  2. DCAP Highlights (PDF)
  3. DCAP Reference List (PDF)
  4. DCAP Reimbursement Form