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FSA • HSA • HRA • COBRA • Transportation

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Flexible Benefits (FSA)

Reimbursement and Substantiation
Substantiation Requirements HRA, FSA Download
Reimbursement Request Form HRA, FSA, Transportation Download
Auto Dependent Care Request Form FSA Download
How to File an On-line Claim HSA, FSA Download
Receipt and Substantiation Form HRA, FSA Download
Medical Necessity Form HRA, FSA Download
IIAS Merchant List General, HSA, HRA, FSA Download
Qualifying Child and Relative Questionnaire General, HSA, HRA, FSA, Consultants Download
Deductible Verification Form FSA Download
Enrollment
Premium Conversion Waiver Form FSA Download
FSA Employee Enrollment Form FSA Download
FSA Employee Guide FSA Download
Administrative
FSA, HRA Rollover Certification HSA, HRA, FSA Download
Additional Card Request Form HRA, FSA, Transportation Download
Authorized Representative Request Form (HIPAA) HRA, FSA Download
FSA Status Change Form FSA Download
Adoption FSA Plan Summary FSA Download
Flex, HRA, HSA Privacy Agreement HSA, HRA, FSA Download
Benefits Termination Form HSA, HRA, FSA, Transportation Download
Email Notification Form HRA, FSA, Transportation Download
Plan Implementation
Design Guide General, HSA, HRA, FSA, Transportation Download
Flex Employer Resource Guide FSA, Consultants Download
Design Guide Workbook HSA, HRA, FSA, Transportation Download
Withdrawal and Direct Deposit
Direct Deposit Form HSA, HRA, FSA, Transportation Download
IRS Publications
IRS Form 2441 - Dependent Care FSA Download
IRS Publication 503 - Dependent Care FSA Download
IRS Publication 502 - Medical Expenses HSA, HRA, FSA Download
DBI Newsletters
Automatic Dependent Care Announcement FSA Download
New Proposed Regulations September 2007 FSA Download
New Debit Card Regulations Handout HRA, FSA Download