Important Documents

• Claim Form – Health FSA
• Claims Guide – Health FSA
• Claim Form – Dependent Care FSA
• Claims Guide – Dependent Care FSA
• Claims Submission Deadline: Appeal for Extension
• OTC Prescription Form
• Direct Deposit Form
• Statement of Medical Necessity
• Vita Flex Carryover Guidelines
• Pre-Tax Plan Maximums

Flexible Spending Accounts

Important Documents

• HSA Quickstart Guide
• HSA Distribution Request Form
• Direct Deposit Form

Health Savings Accounts

Important Documents

• Claim Form – HRA
• Direct Deposit Form

Important Documents

• Claim Form – Parking
• Direct Deposit Form