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Health Reimbursement Arrangement (HRA)

Most Frequently Used Forms
Additional Card Request Form HRA, FSA, Transportation Download
Authorized Representative Request Form (HIPAA) HRA, FSA Download
Automatic Orthodontia Request Form HRA, FSA Download
Benefits Termination Form Reimbursement Accounts HSA, HRA, FSA, Transportation Download
Direct Deposit Form HSA, HRA, FSA, Transportation Download
IRS Publication 502 - Medical Expenses HSA, HRA, FSA Download
IRS Publication 969 - Reimbursement Accounts (FSA, HSA, HRA) HSA, HRA, FSA Download
Medical Necessity Form HRA, FSA Download
Receipt and Substantiation Form - Debit Card Transactions HRA, FSA Download
Reimbursement Request Form HRA, FSA, Transportation Download
Substantiation Requirements Refresher HRA, FSA Download
Reimbursement and Substantiation
90% Rule Merchant List General, HSA, HRA, FSA Download
Automatic Orthodontia Request Form HRA, FSA Download
Deductible Verification Form Reimbursement Accounts HRA, FSA Download
IIAS Merchant List HSA, HRA, FSA Download
Medical Necessity Form HRA, FSA Download
Qualifying Child and Relative Questionnaire General, HSA, HRA, FSA, Consultants Download
Receipt and Substantiation Form - Debit Card Transactions HRA, FSA Download
Reimbursement Request Form HRA, FSA, Transportation Download
Substantiation Requirements Refresher HRA, FSA Download
Enrollment
Participant Guide HRA HRA, Consultants Download
Administrative
Additional Card Request Form HRA, FSA, Transportation Download
Authorized Representative Request Form (HIPAA) HRA, FSA Download
Benefits Termination Form Reimbursement Accounts HSA, HRA, FSA, Transportation Download
MSP Reporting Requirements for HRAs HRA Download
Privacy Agreement Reimbursement Accounts HSA, HRA, FSA Download
Rollover Certification FSA HRA HSA, HRA, FSA Download
Plan Implementation
Employer Resource Guide HRA HRA Download
Withdrawal and Direct Deposit
Direct Deposit Form HSA, HRA, FSA, Transportation Download
IRS Publications
IRS Publication 502 - Medical Expenses HSA, HRA, FSA Download
IRS Publication 969 - Reimbursement Accounts (FSA, HSA, HRA) HSA, HRA, FSA Download