WebFlex Facts, 1200 River Avenue, Suite 10E, Lakewood, NJ 08701, www.FlexFacts.com 732-640-5951 Transit and Parking Claim Form Personal Information Full Name: Last First M.I. Employer: Last Four Digits of Your Social Security Number Phone: ( ) E-mail: If your address has changed please list the new address below. New Address:

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WebFill out Flex-Pay Reimbursement Claim form within a few clicks by using the instructions listed below: Pick the document template you need from our collection of legal forms. Choose the Get form button to open it and start editing. Submit … WebP.O. Box 21367 Billings, MT 59104-1367 Request for Flex/DCA Reimbursement Phone: 866.857.8182 Fax: 844.791.8315 Email: [email protected]. Employer Name Employer Group Number intersport traralgon website

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Webq What is a health savings account (HSA)? a An HSA is a tax-advantaged personal savings account that can be used to pay for medical, dental, vision and other qualified expenses now or later in life. To contribute to an HSA you must be enrolled in a qualified high-deductible health plan (HDHP) and your contributions are limited annually. The funds can even be … WebSign and date the claim form or your claim will be delayed! No claims can be processed without an employee signature . Submit fully completed and signed claim form along with all required documentation to: HR Simplified, Inc. Attn: Spending Account Department 5320 West 23 rd Street, Suite 350 Minneapolis, MN 55416 Phone: 888-318-7472 WebFlexFacts FSA OTC Products FAQs: FlexFacts Health & Dependent Care FSA The Flexible Spending Account (FSA) / Premium Only Plan (POP) and Commuter Benefits options help you manage out-of-pocket medical, dependent care, and/or commuter-related costs and lowers your taxable income by setting aside your contribution amount before … new flyer competitors