FSA
Dependent Care Recurring Expense Form
Complete this form to request automatic reimbursement from your Dependent Care Assistance Plan (DCAP) account. Contributions will be reimbursed to you on a per-pay-period basis. By completing this form you will not need to provide continuing documentation. Please complete all fields and include appropriate documentation stating your child will be attending throughout the year or … More >>
Debit Card Request Form (Replacement or Additional)
Complete this form to request replacement of a lost or stolen debit card or to request additional cards for dependents.
Employee Direct Deposit Authorization Form
Use this form to request that a claim reimbursement be deposited directly into your bank account. Instructions for completing this form: Fill in all fields below Attach voided check (no deposit slips) Sign and date form. If the account is not in your name alone, the other account holder must also sign and date form.
Medical Claim Form (Reimbursement or Card Substantiation)
How to Submit a Claim Form All sections of the claim form must be completed in order to receive reimbursement, including signature and date. Claim Form Section 1: Employee Information The following information must be included for each claim: Employee (Participant) Social Security Number Employee Name Employee Address Employee Phone Number Claim Form Section 2: … More >>
Who is Captain Contributor?
Is it a bird? A plane? A flying tax man?!? After a sequence of freakishly unlucky events, a once meek tax man is transformed into a super hero! Captain Contributor’s origin story and his mission to help people save on their taxes is out of this world. And what’s with that form-fitting leotard? Watch this video to discover … More >>
Captain Contributor Explains FSAs
” Flexible Spending Accounts are employer-sponsored accounts that enable you to set aside money from each paycheck, before taxes, to help pay for IRS-approved, out-of-pocket medical expenses for yourself and your dependents. Learn more! Captain Contributor – Benefits Super Hero Read FSA Comic Volume 2 Read FSA Comic Volume 1 Read FSA Fact Sheet Captain Contributor Explains … More >>
Flexible Spending Accounts
Flexible Spending AccountsAn 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. Learning center videos forms library
Learning Center
Learning CenterWelcome to the Learning Center. Here you will find a wealth of information about your tax-advantaged benefits, including FSAs, HSAs, HRAs, and COBRA. FSA HSA HRA COBRA
Forms Library
Forms LibraryWelcome to the Forms Library. Here you will find the most commonly used forms associated with filing claims, requesting reimbursements, and enrolling in benefits. FSA HSA HRA
Captain Contributor Explains Planning for Expenses
” If your company offers an FSA or HSA, it’s a good idea to sign up for one. They can help you save on taxes while putting aside money for healthcare expenses. But the question always comes up – how much money do I need to set aside? Watch this video to learn more about planning … More >>
Captain Contributor – Your Benefits Super Hero
” Hello! I’m Captain Contributor. I want to help you make the most of your employer-sponsored benefits and save money on your taxes! Captain Contributor – Benefits Super Hero An FSA, or Flexible Spending Account, is an employer-sponsored account that enables you to set aside money from each paycheck, before taxes, to help pay for IRS-approved, out-of-pocket … More >>
Captain Contributor Explains Tax Savings
” When considering an FSA, HSA, or HRA, you may be wondering – why should I sign up? The answer is simple – saving money! Each account can save you money, but there are differences between them. Watch this video to learn more about tax savings! Captain Contributor – Benefits Super Hero Captain Contributor Explains ICHRAs Captain … More >>
Captain Contributor Explains How FSAs Work
” Did you know there are different types of FSA accounts – health, limited purpose, and dependent care? Each account can save you money, but there are differences between them. Also find out what happens if you have money left in your account at the end of the plan year. Watch this video to learn … More >>
Captain Contributor Explains Preparing for Enrollment
“ When benefits meetings roll around each year, many people don’t fully understand their benefits package, and blindly make important healthcare choices. This year, challenge yourself to do a little preparation so you can make the best possible decisions for you and your family. Watch this video to learn more about enrolling in your benefits. Captain … More >>
Captain Contributor Explains Benefits Debit Cards
” No matter where you go – doctors’ offices, grocery stores, retail shops, and more – you can use a debit or credit card to pay for goods and services. But did you know you can also use a debit card that’s linked to your healthcare benefits accounts? Watch this video to learn more about … More >>
7 Facts About FSAs and HSAs That Employees Should Know During Open Enrollment
Open enrollment season for benefits is a time for making important decisions regarding healthcare expenses for you and your family. In addition to health insurance options, many companies sponsor tax-advantaged consumer directed healthcare accounts, like Flexible Spending Accounts (FSAs) or Health Savings Accounts (HSAs). FSAs and HSAs are popular because they can help you save … More >>
