Tools
Your AccountLogin to check your FSA, HRA or T&P account information.
Login to check your COBRA account information.
Eligibility Login
Login to access your Enrollment and Eligibility account information.
Eligible Expense List
What expenses are eligible for reimbursement under a cafeteria/flex plan? Check your eligible expenses!
Tax Calculator
How much can you save in taxes by participating in cafeteria/flex and transit & parking plans? Check your tax savings! Enrollment is easy!
Online Claims
Entering your claim online is quick and convenient. Click here.
Note: Pop-Up Windows 
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FSA General Forms
All forms are interactive. However, if you have an address or email change, you can do so by accessing Your Account, choosing Personal Information and updating your information. In addition, if your employer offers our direct deposit or payment card option for spending accounts, you may perform these functions as well in Your Account.
All items open in new windows.
English forms
Direct Deposit Authorization/Stop Direct Deposit
Payment Card Request
(Dependent cards are not applicable to the T&P Plans)
Authorization/Disclosure of Protected Health Information
Revocation Authorization/Disclosure of Protected Health Information
Healthcare Dispute Form - VISA
(to report credit card fraud)
Letter of Medical Necessity
Download and take to licensed provider
Spanish forms
Change of Address Spanish version
Direct Deposit Authorization/Stop Direct Deposit Spanish version
Payment Card Request Spanish version
PDF Help
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