Forms & Brochures

FlexToday provides customized benefit programs.

Reimbursement Forms
Medical
Recurring Orthodontia
Day Care
Recurring Day Care
Commuter
Letter of Medical Necessity
Claims Kit

Miscellaneous forms and materials
Dependent Definition
Direct Deposit
Domestic Partner Certification
Med-FSA COBRA Election Form
Reset User Name/Password
Check By Fax FSA
COBRA – Credit Card Pmts
COBRA – Electronic Pmts
COBRA – Check By Fax

Enrollment Brochures
Flex Plan
Commuter Choice
Eligible Medical Expenses
Medical Flex Spending
Dependent Day Care
Debit Cards
Health Savings Accounts
Limited Med-FSA

HIPAA Forms
Privacy Release Form
Request For Accounting
Request For Alternate Communication
Request To Inspect

We publish our forms in Adobe Acrobat (.pdf) format. Adobe Acrobat Reader is a freely available software program from Adobe If you click on the “Get Acrobat Reader” symbol below, you will be directed to the Adobe web site.