Flex Download Center

Following are forms and documents that can be reviewed online or downloaded to your computer. Many of the files are in the Adobe Acrobat format. In order to open and print these files, you will need to have the free Adobe Acrobat Reader installed on your machine.

DOWNLOAD INSTRUCTIONS

Click the form or document that you would like to view. If your Acrobat Reader is integrated into your browser, the form will simply open in a Web browser window. From there, you can print the form directly from your browser, or select "Save" to copy the form to your local computer. If Adobe Acrobat is not integrated into your browser, right click the link and choose the "Save Target As..." to download the file. After making sure that you have Adobe Acrobat Reader installed on your machine, click on the .pdf file you downloaded to open and print the form.

Reimbursement Account Forms
Health Care Claim Form (hcform.pdf)
Health Care Reimbursement Account claim form. This is an electronic form that may be completed and printed for FAXing or mailing.
Dependent Care Claim Form (Dcform.pdf)
Dependent Care Reimbursement Account claim form. This is an electronic form that may be completed and printed for FAXing or mailing.
Direct Deposit Set-up Form (Ddfrm.pdf)
Use this form to set-up direct deposit reimbursements into your checking or savings account.

COBRA
ACH Payment Authorization (ACH_authorization-e.pdf)
Use this form to have your monthly continuation premium automatically deducted from your checking account. Your authorization form must be received by the 25th of the month to be effective for the premium that is due for the next month (e.g., the form must be received by June 25th in order for us to pull the funds on July 1st for July’s premium). Please keep in mind that we will continue deducting payments from your account until you direct us in writing to stop the automatic payments. You must tell us in advance when you want your payments and coverage to end.