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|General FSA Claim Form|
|HRA Claim Form||
|State of Arizona Employees|
|Arizona Board of Regents FSA Claim Form|
|Arlington County FSA Claim Form|
|State of California FlexElect||
|State of California Pre-Tax Parking||
|California State University|
|City County Insurance Services (CIS)|
|San Diego County Employees|
|State of Colorado Employees|
|State of Delaware Employees|
|State of Iowa Employees|
|Iowa State University Employees|
|State of Kansas Employees|
|State of Missouri Employees|
|State of Nebraska Employees|
|University of Colorado Employees|
|Vassar HRA Claim Form||
Your insurance Explanation of Benefit (EOB) will almost always provide all of the necessary information.
For Dependent Care FSA claims, you can simply have your provider sign the claim form, and no other documentation is required.
The online portal is the fastest and easiest way to submit your claim. All that you have to do to submit your claim online is log into ASIFlex's secure portal, fill out an online claim form and upload your documentation (must be in PDF format).
Sign up for Direct Deposit to insure that your funds are sent to you quickly. If you aren't signed up for direct deposit, you will receive a check in the mail.
You can always call ASIFlex directly at 1-800-659-3035 with any questions that you have.