125Quick Forms *     

 Flexible Spending Account

	125Claim Form (FSA - DCAP and/or  HRA) - fillable
	125Claim Form (HRA only) - fillable
	125Claim Instructions
	Day Care Provider form

Guidelines & Information

	Over the Counter (OTC) - New Changes 2011
	FSA Eligible Expenses (sample list)  and OTC rules for 2011
	Over the Counter (OTC) New 2011 Changes and Debit Cards Use
	FSA Non-Eligible Expense Examples
	Healthcare Pricing Guide - 2011
	A Quick Guide for Reimbursement
	A Flexible Spending Account. Is it Right for You?
	Dependent Care vs. Dependent Tax Credit Guide - 2010
	Determine your Pre-Tax Election & Pay Check Savings (under Worksheet)

Transportation Account

	Parking Reimbursement Form
	Transportation Personal Receipt

What is eligible and what is not !

 *Reminder:

Your Summary Plan Description (SPD) will describe your specific eligible claim types. If you have any specific questions, please contact your HR department.

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This site was last modified March, 2011