Flexible Spending Accounts

Forms to initiate pre-tax payroll deductions for unreimbursed medical and dependent care expenses are available from the third party administrator, FLEXFACTS. Deductions are authorized on a yearly basis during the open enrollment period.

FLEXFACTS
www.flexfacts.com
7 Grant Ave, Lakewood, NJ 08701
Phone: 877-94-FACTS (32287)
Fax: 877-747-8564
E-Mail: Claims@flexfacts.com
Flex Facts Claim Direct Deposit Form
Flex Facts Claim Direct Deposit Form
Flex Facts Claim Direct Deposit Form.pdf
17.0 KiB
279 Downloads
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Flex Facts Claim Form 2015
Flex Facts Claim Form 2015
Flex Facts Claim Form 2015.pdf
23.8 KiB
172 Downloads
Details