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FSA Resources

Click any image to download the associated publication or form in PDF format. If you don't see the form you're looking for, you can request one via our contact us form.

Health Claim Form

Health Care Reimbursement Form
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Dependant Care Claim Form

Dependent Care Reimbursement Form
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Transit and Parking Claim Form

Transportation/Parking Reimbursement Form
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Health Claim Form

Ins. FSA Claim Form
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Dependant Care Claim Form

Parking & Transit Change Form
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Transit and Parking Claim Form

HRA CLaim Form
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Dependant Care Claim Form

Flex Life Event Form
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Transit Parking flex program 2012

Transit & Parking Info Pack
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Max Flex Info Pakect with Debit

Max Flex Info Pakect with Debit
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FSA WebSite Login

If you are an employee click "Participant Login" if you are an employer click "Employer login."

Important Information:
Do Not Use "Administrator Login"

Forgot Your Password?

COBRA Resources

COBRA forms are customized for individual clients. You can request a form using the contact us page for specific COBRA documents.

 

WebCOBRA Login

Only HR Personnel can access the COBRA site at this time. For assistance logging-in contact Mary Kelner at our office via email or call 630-366-7415.

Forgot Your Password?

FMLA Resources

Click any image to download the associated publication or form in PDF format. If you don't see the form you're looking for, you can request one via our contact us form.

Employee Medical Certification Form

Employee Medical Certification Form
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Family Member Medical Certification Form

Family Member Medical Certification Form
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FMLA Fact Sheet

FMLA Fact Sheet
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FMLA Overview

FMLA Overview
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Return to Work Form

Return to Work Form
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Family & Medical Leave Request Form

Family & Medical Leave Request Form
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FMLA Source Website Login

For both employee and HR login, click the link below.

Forgot Your Password?

HSA Resources

Click any image to download the associated publication or form in PDF format. If you don't see the form you're looking for, you can request one via our contact us form.

HSA Facts

HSA Facts
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HSA Facts

2012 Indexed Benefit Plan Figures
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Other Frequently Requested Documents

Click any image to download the associated publication or form in PDF format.

The Leading Edge Brochure
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Mid America Vision Information
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