Next Generation Enrollment, Inc. ~ FSA/HRA Forms and Materials

Below will you find a complete listing of Flexible Spending Account and Healthcare Reimbursement Arrangement forms available for download as Adobe PDFs. These documents are meant to help you learn about and manage your Flexible Spending Account or Health Reimbursement Arrangement Plan.

Should you have questions or needs that cannot be handled from our website, please call our office at 888-266-1732.

Forms:

• How to access and use the NGE Flex Plan Claims System

• Healthcare Flexible Spending Account Reimbursement Form

• Dependent Care Flexible Spending Account Reimbursement Form

• Health Reimbursement Arrangement (HRA) Reimbursement Form

• Direct Deposit Form

• HIPAA Authorization Form

• Letter of Medical Necessity

Guides and Worksheets:

• Tax Savings Illustrations for Flexible Spending Plans

• Worksheets for Health and Dependent Care Annual Elections

• Listing of Eligible Expenses for Healthcare Flex Plan

• Full Enrollment Kit

• Additional information on Benefits MasterCard