Forms and Information

Question: How do I authorize others to discuss my account?
Answer: Please fill out and submit to us the following form: Authorization for Release of Information

Question: How do I request new or additional debit cards?
Answer: Please fill out and submit to us the following form: Debit Card Request Form

Question: How do I request funds to be deposited into my bank account?
Answer: Please fill out and submit to us the following form: Direct Deposit Authorization Form

Question: How do I request reimbursement for dependent care?
Answer: Please fill out and submit us the following form: Recurring Expense Form DCAP

Question: How do I authorize others to discuss my account?
Answer: Please fill out and submit to us the following form: Authorization for Release of Information

Question: How do I request new or additional debit cards?
Answer: Please fill out and submit to us the following form: Debit Card Request Form

Question: How do I request funds to be deposited into my bank account?
Answer: Please fill out and submit to us the following form: Direct Deposit Authorization Form

Question: How do I transfer my HSA from another provider?
Answer: Please fill out and submit to us the following form: HSA Transfer Form

Question: How do I request reimbursement from my HSA?
Answer: Please fill out and submit to us the following form: HSA Request Distribution

Question: How do I authorize others to discuss my account?
Answer: Please fill out and submit to us the following form: Authorization for Release of Information

Question: How do I request new or additional debit cards?
Answer: Please fill out and submit to us the following form: Debit Card Request Form

Question: How do I request funds to be deposited into my bank account?
Answer: Please fill out and submit to us the following form: Direct Deposit Authorization Form

Question: How do I submit a claim for reimbursement?
Answer: Please fill out and submit to us the following form: Debit Reimbursement Substantiation Claim Form

Question: What is COBRA?
Answer: Please see our brochure that explains COBRA. COBRA Frequently Asked Questions

Question: How do I make a COBRA Payment online?
Answer: Please see our COBRA Payment brochure for full payment details: How to Make a COBRA Payment Online