Printable Forms

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