Forms:

 Medical Reimbursement Claim Form

       Medical Claim Filing Instructions

 Dependent Care Claim Form

       Dependent Care Claim Filing Instructions

 Form 2441 - Dependent Care Expense Tax Form

       Form 2441 Instructions

 Direct Deposit Enrollment

 Medical FSA/Dependent Care Enrollment Form

 Medical FSA/Dependent Care Change in Status

 HRA Change in Status

 Change in Status Matrix

 

What is a PDF?                     

PDF stands for "Portable Document Format." These files are produced by Adobe's Acrobat software. With this software, PDF files can be created from any application.

Adobe, Acrobat, the Get Acrobat logo, and the PDF logo are trademarks of Adobe Systems Incorporated

Reimbursement Calendars:

2008 Reimbursement Calendar

2009 Reimbursement Calendar

Note: Dependent Care is reimbursed daily if funds

are available in your account.

Other Information:

Over-the-Counter Guide

Guide to allowable expenses

FSA Debit card retail partners

EasyHRA participating pharmacies

 

Customer Service Information:

Hours:       M - F 8:30 - 5:00 EST/EDT

Toll-Free:   1-800-598-6843

Fax:          1-800-598-6844

e-mail:      claims@elkinassociates.com

HIPAA Information:

 HIPAA Privacy Notice

 Release Authorization

 HIPAA Policy and Procedures

Why do we use PDF?

Adobe Acrobat is a multi-platform software publishing package which  means that all computers and operating systems (Macintosh, Windows, Unix and DOS) can view PDF files.  Also, PDF files can be created from any application. This ensures that PDF files will look and print the same as the original document.
Download the free Adobe Acrobat Reader from Adobe's Web Site.