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Reimbursement Account Enrollment Form

For Employees Experiencing a Qualifying Life Event

If you are experiencing a qualifying life event, such as marriage, divorce, birth, or adoption, please complete an online request through the Duke@Work self-service website to enroll or make changes to the health care and/or dependent care reimbursement accounts. The request and required supporting documentation must be submitted within thirty (30) days of the event.

Form NameFormat
Reimbursement Account Enrollment Form
(use the "Qualifying Life Event Enrollment" link)


For Newly Hired Employees

If you are a newly hired employee, you may enroll online through the Duke@Work self-service website to participate in the health care and/or dependent care reimbursement accounts. Make your benefit selections carefully as you will not be able to make changes afterward until the next annual open enrollment period, unless you have a qualifying life event. Enrollment must be completedduring the first thirty (30) days after your date of hire.

✝ If you are having trouble accessing Duke@Work please contact your departmental payroll representative. If you are having difficulty with the benefit enrollment link, please contact the HRIC at 684-5600.


Benefits - Dependent Care Reimbursement Account, Benefits - Health Care Reimbursement Account, Benefits - Reimbursement Accounts