Forms & Resources

EMPLOYEE ENROLLMENT FORMS & TOOLS

MyAmeriflex Registration Instructions

How To Use Your MyAmeriflex Card

How To Use Your MyAmeriflex Card (Spanish)

5-Step Substantiation Process for card transactions

CRA Quick Reference Guide

HSA Quick Reference Guide

FSA Quick Reference Guide

Customized Enrollment Form

CRA Online Enrollment Instructions

FSA Online Enrollment Instructions

FSA Enrollment Video

HSA Enrollment Form

HSA Presentation

EMPLOYEE TOOLS

Claim Form

Claim Form (Spanish)

CRA Change of Election Form

Employee Request for Service

Estimate Your FSA Contributions Worksheet

HRA Activation Form

Letter of Medical Necessity

Substantiation Request Form

Substantiation Request Form (Spanish)

MyAmeriflex Participant Portal Demonstration Video

Ameriflex Simple Substantiation Video

Getting Reimbursed for Orthodontia Expenses

Refund Request

COBRA FORMS

COBRA Open Enrollment Form

COBRA Participant Recurring ACH Form

COBRA Qualifying Event Submission Form

COBRA Request for Service Form

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