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Home » Flexible Spending Enrollment Form
All City of New Orleans employees (except OPSO and OPSO) must enroll for Healthcare and/or Dependent Care FSA Benefits through the ADP system.
CLICK HERE TO ENROLL: www.myadp.com
Please complete the form below to enroll in UnitedHealthcare's Flexible Spending Account Plan or make changes to your existing account.
ONLY personnel from OPCD and OPSO may complete the form below to enroll in, or make changes to, United Healthcare's Flexible Spending Account Plan for Healthcare and/or Dependent Care benefits. Commuter benefits are not available for OPCD or OPSO personnel.
If you are not employed by OPCD or OPSO, you must enroll in, or make changes to, United Healthcare's Flexible Spending Account Plan for Healthcare and/or Dependent Care benefits within the ADP self-service portal. Click here to enroll: www.myadp.com
Fields marked with * are required.
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This agreement will remain in effect for the Plan Year unless changed for reasons stated in the terms and conditions of the Plan. By typing my name, I certify that I have examined this agreement and understand and agree to comply with the terms and conditions of the Plan. If this is a change in status, I certify that this change is consistent with the qualifying event. I agree to hold UnitedHealthcare Benefit Services and my employer harmless from any liability to my participation in this plan. *:
Last updated: 1/11/2024 9:57:32 AM
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