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Flexible Spending

Why choose an FSA?

2021 Healthcare FSA.pdf 3.57 MB (Last Modified on October 30, 2020)

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FSA Annual Enrollment Announcement

2021 FSA Annual Enrollment Announcement.pdf 30.18 KB (Last Modified on October 30, 2020)

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FSA Information and Worksheet

NIHP - FSA Information and Worksheet.pdf 91.85 KB (Last Modified on October 30, 2020)

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Flexible Spending - Election Form

FSA Election Form.pdf 51.9 KB (Last Modified on October 30, 2020)

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FSA Eligible and Ineligible Expenses

FSA Eligible and Ineligible Expenses.pdf 88.89 KB (Last Modified on October 30, 2020)

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Flexible Spending - Direct Deposit Form

Direct Deposit Form.pdf 32.04 KB (Last Modified on October 30, 2020)

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Flexible Spending - Claim Form & Filing Instructions

FSA Claim Form and Filing Instructions.pdf 64.58 KB (Last Modified on October 30, 2020)

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Flexible Spending - Medical Necessity Form/Over the Counter Authorization

FSA Medical Necessity Over the Counter Authorization Form.pdf 42.95 KB (Last Modified on October 30, 2020)

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New Technology, Increased Flexibility , Innovative Changes

New Technology Increased Flexability Innovative Changes.pdf 72.39 KB (Last Modified on October 30, 2020)

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