Forms and Guides

Employee education and FAQs for the Adoption Assistance benefit account.

This flyer/infographic provides a brief overview of Combined Billing and how it works.

List of eligible expenses for a Dependent Care FSA.

This form details where women can find appropriate abortion care; such as employee benefits, travel reimbursements, travel expenses and more.

Employee guide to parking and transportation pre-tax benefit accounts.

Employee educational handout with list of FSA eligible expenses.

Beneficiary Designation form for the Flexible Spending Account benefit to designate the individual/s that may have certain obligations and responsibilities to file claims and seek reimbursement under the terms of the plan in the event of your death.

A participant overview of the Health Care FSA (i.e. contribution limits, eligbile expenses, tax benefits, etc.)

This guide provides you step-by-step instructions on how to submit a claim online.

A list of eligible expenses for a Health Savings Account.

List of eligible expenses for a Limited Purpose Flexible Spending Account.

NueSynergy benefit debit card FAQs and transaction substantiation guide.

Fill out this form if you are a participant wanting to order a debit card for yourself or any eligible dependent(s).

Sample HRA implementation timeline for both the initial account setup and transition from a current administrator.