
FSA Store
Finding eligible expenses to spend your FSA funds on is easy! FSAStore.com contains ONLY items that are FSA eligible, and also offers tools like an eligibility list and FSA calculator to help you manage your expenses!
Flex Claim Form [FILLABLE PDF]
Direct Deposit Authorization [ PDF]
Letter of Medical Necessity [ PDF]
Eligible Expenses [ PDF]
Log In – My Flex (consumer/participant) Portal Quick Start Guide [ PDF]
Log In – Eflex (employer) Portal Quick Start Guide [ PDF]
Percentage of Use Form [ PDF]
Capital Expense Worksheet [ DOC]
Debit Card Brochure[ PDF ]
Mobile Application Brochure[ PDF ]
Advantage Administrators HIPAA Privacy Policy [ PDF ]
HSA Brochure[PDF]
HSA DISTRIBUTION REQUEST FORM[PDF]
HCB Investment List – 1.31.2021
Eligible Expenses [ PDF]
Reimbursement Cover Claim Form [ FILLABLE PDF]
HRA Flyer[ PDF]
Designation Of Beneficiary[ PDF]
Participant Loan Application[ PDF]
Salary Deferral Election – Non-Roth [ PDF]
Salary Deferral Election – Roth [ PDF]
Notice of Separation From Service [ ONLINE FORM]
Defined Contribution Employer Brochure Here.[ PDF]