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How Flex Plans Work

General Information

Qualified Expenses



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Download Flex Spending Forms
(You will need Adobe Acrobat Reader to view these forms. If you do not have Acrobat Reader, click here to download the software.)

Flexible Spending Claim Form (PDF file)

Flexible Spending Claim Form (with 2.5 month extension) (PDF file)

HRA Claim Form (PDF file)

Direct Deposit Authorization Claim Form (PDF file)

Orthodontia Claim Form (PDF file)

Dependent Care Information Form (PDF file)

Debit Card Substantiation Form (PDF file)

Authorization to Use or Release Information (Iowa) (PDF file)

Transportation Spending Account Claim Form (PDF file)

Claim Form for Participant Reimbursement (PDF file)