HomeResources

Resource Center

Expand your benefits knowledge and stay up to date on important healthcare legislation

Quick Navigation

Forms & Documents

Enrollment

FSA Enrollment Form FSA Enrollment Form (Spanish) HSA Enrollment Form HSA Presentation

Administrative

FSA CARES Act Over-the-counter Amendment HRA CARES Act Over-the-counter Amendment Transaction Reversal Request Form

COBRA Forms

COBRA Open Enrollment Form COBRA Participant Recurring ACH Form COBRA Request for Service Form COBRA Termination Appeal Form

For Employees

Claim Form Claim Form (Spanish) CRA Change of Election Form FSA Eligible Expenses FSA Eligible Dental Expenses HSA Eligible Expenses Employee Request for Service HRA Activation Form Letter of Medical Necessity Offset Request Form Orthodontia Form Refund Request Substantiation Request Form Substantiation Request Form (Spanish) Courtesy Flip Request Form

Tools & Calculators

Compliance Decision Tool Estimate Your FSA Contributions Worksheet FSA Employer Savings Calculator PCORI Fee Worksheet Takeover Spreadsheet Template Upload Spreadsheet HSA Savings Calculator