Documents and forms

Employer
2018-2019 Payroll Calendar
FSA Plan Amendment - New Permitted Election Changes
FSA Plan Amendment - Remove Premium Payment
Health Care Reform Amendment for $2600 Limit
take care by WageWorks File Specifications
Insurance Carrier Co-pay Information Form
Change in Status Overview
Authorization for Electronic Funds Transfer
How to ensure ACH Authorization Approval
MICR signature form
Form 5500 completion for FSA or HRA
How to request discrimination testing
Discrimination testing sample worksheet with instructions
Employee / Participant
Health Care Claim Form
Dependent Care Claim Form
Health Reimbursement Arrangement Claim Form
Commuter Reimbursement Claim Form
Adoption Reimbursement Claim Form
Participant Letter of Medical Necessity
Participant Change In Status Form
Participant HIPAA Authorization Form
Participant Personal Information Change Form

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