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Employee Center - OneStartChange of Staus form
University Human Resource Services

Indiana University
Benefits Change Connection

Dependent Care Provider or Cost

A change in your dependent care provider or cost will allow you to make a change to the Tax Saver Benefit (TSB) Plan Part C: Dependent Care Reimbursement Account.

To make a change to TSB Part C, you will need to complete Step 1 the Change of Status form and Step 2 the personalized benefit enrollment form. Step-by-step instructions appear on the TSB Plan pages below. You must make the change within 30 days.

A letter from the provider will be required documentation.

Tax Saver Benefit (TSB) Plan

 

Forms

Change of Status form
  - Online
  - PDF