Flexible Spending Accounts

News & Updates:

July 1, 2009 New Regulations for Use at Pharmacies

CCPS offers the ability to pay for healthcare through a IRS Section 125 Plan and offers two Flexible Spending Accounts (FSAs) , which are both administered through HFS Benefits .

The two types of Flexible Spending Accounts are:

1. Dependent Care Flexible Spending Accounts (e.g. childcare)
2. Health Care Flexible Spending Account (out-of-pocket healthcare expenses)
   

Read what you need to know about FSAs here in the Employee Information Guide for Flexible Spending Accounts.

Medical Reimbursement/Claim Form (.pdf)

Dependent Care Reimbursement/Claim Form (.pdf)

Debit Card Substantiation Form (.pdf)

View Claims Status Online

Flexible Compensation Program (Plan Summary) (.pdf)

FSA Facts (.doc)

Request For Replacement/Additional FSA Card (. doc )

FSA Spousal Authorization Form (.pdf)

Over-the-Counter/Dual Purpose Letter of Medical Recommendation Form (.pdf) (For OTC medications beginning 1/1/2011)