Employee Forms

Claim form for all Medical Flexible Spending Account and Dependent Care Accounts. Download the form and open in Adobe Reader or Acrobat for electronic signature. Forms can be returned to Advantage Benefits Plus via e-mail, fax, or mail. Please send with all required documentation if applicable. 

Contact us to file a claim today. 

Claim form for all Qualified Transportation Benefits. Download the form and open in Adobe Reader or Acrobat for electronic signature. Form can be returned to Advantage Benefits plus via e-mail, fax, or mail. Please send with all required documentation if applicable. 

Contact us to file a claim today. 

Find out what can and cannot be used with your Medical Flexible Spending Accounts

 

Receipt requirements when filing a claim.