Flexible Spending Accounts Forms

Flexible Spending Account Enrollment Form

Flexible Spending Account Claim Form
Expenses must be incurred prior to submitting a request for reimbursement. Approved FSA claims are processed within 7 – 14 business days.

Flexible Spending Account Authorization for Direct Deposit Form

Eligible / Ineligible Expenses

HCRA Most Questioned Expenses

DCRA Most Questioned Expenses