ET-1518
Form State Employer

Flexible Spending Account Continuation Election Form

Employers must issue this notice to employees within 14 days of becoming aware of a qualifying event that will cause an employee to lose eligibility to participate in the FSA or limited purpose FSA program(s).

Income Continuation Insurance for Employers

ICI is a voluntary “income replacement” benefit payable to an enrolled employee if they become disabled. This program is only
offered to employers already participating in the WRS.