Seattle Department of Human Resources Susan Coskey, SDHR Director


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Change in Family Status

Deferred Compensation

All Deferred Compensation forms can be found on the Plan's dedicated website under "FORMS".

Family Medical Leave

Flexible Spending Account

  • FSA Reimbursements for Claims Only
  • pdf icon  Claim Reimbursement Form
    Form used to submit reimbursement request for eligible health and dependent care expenses.
  • word document icon FSA Change Form
    Make allowable changes to current address, status or contributions for health and/or dependent care.
  • pdf icon Benefits Card/Direct Deposit Request Form
    Form to authorize reimbursements to be deposited directly into your bank account and/or request for pre-paid Benefits Card to pay for qualified health care expenses up front.

Life Insurance

Long Term Disability Insurance

For the LTD claims packet, please contact your department's benefits representative.

Medical & Health Care


Open Enrollment

Paid Parental Leave

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