Flexible Spending Accounts

An FSA, or Flexible Spending Account, is an account sponsored by your employer that enables you to set aside money from each paycheck, before taxes, to help pay for IRS-approved, out-of-pocket medical expenses for you and your dependents.

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Flexible Spending Accounts

Authorization for Release of Information Form

Debit Card Request Form (Replacement or Additional)

Dependent Care Recurring Expense Form

Employee Direct Deposit Authorization Form

FSA Medical Care Recurring Expense Form

Medical Claim Form (Reimbursement or Card Substantiation)

Benefit accounts