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Flexible spending claim form

myuhc.com

FLEXIBLE SPENDING ACCOUNT.

MAIL CLAIM FORM TO: UnitedHealthcare PO Box 981178 El Paso, TX 79998-1178 Fax: (915) 781-1085 Phone: (877) 311-7849 FLEXIBLE SPENDING ACCOUNT (FSA) CLAIM FORM

provider.uhc.com

FLEXIBLE SPENDING ACCOUNT.

Policy Number: 100300 Fax: (518) 454-4844 Phone: 866-CAT-4215 MAIL or FAX CLAIM TO: FSA Unit - P.O. Box 925 Albany, NY 12201-0925 FLEXIBLE SPENDING ACCOUNT CLAIM FORM

cignaforhealth.com

Flexible Spending Account.

Flexible Spending Account (FSA) Reimbursement Form Please complete this form and mail or fax with supporting documentation to: CIGNA, Flexible Benefits Administration ...

download.paychex.com

Flexible Spending Account.

Flexible Spending Account (FSA) Reimbursement Claim Unreimbursed Medical Expenses ... will be processed within 2 business days upon receipt of the completed claim form ...

flex-plan.com

Company Code COMPANY NAME.

2. Do not staple any documentation to claim form, please tape to separate sheet or include loosely in envelope. Do not send originals (all claims are stored ...

ebc.state.ok.us

Oklahoma Employees Benefi.

Flexible Spending Spending Account Information EBC FSA Calculator FSA Claim Form ... health care flexible spending accounts ...

acgov.org

Flexible Spending Account.

Flexible Spending Accounts. Eligible employees can ... You can download the appropriate claim form through the box to the right, or contact the Employee Benefits Center (EBC ...

ebsrmsco.com

Flexible Spending Account.

EBS-RMSCO provides flexible spending account administration, with FSA claims ... Enrollment Forms ; Communication Materials; Claim Submission Forms ; FSA Claims Processing

community.intuit.com

W-2 Box 10. Is flexible s.

Client has $1000 reported in box 10 of form W-2. He states this is his flexible spending account.

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