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Flexible Spending Plans

Medsurety Request for Reimbursement Form

Employees who participate in our Flexible Spending Plan (Medical or Dependent Care) submit reimbursement requests to Medsurety.

MEDSURITY - Request for Reimbursement.pdf 152.81 KB (Last Modified on January 5, 2019)

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Flex Frequently Asked Questions

2022-Medsurety -FAQ for New Hire_FSA-with Grace Period.pdf 586.02 KB (Last Modified on December 2, 2021)

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Flexible Spending Eligible Expenses

FSA_Eligible and Ineligible Fact Sheet-2022.pdf 172.13 KB (Last Modified on December 2, 2021)

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Medsurety Direct Deposit Form

MEDSURETY - Direct Deposit Form.pdf 275.38 KB (Last Modified on January 5, 2019)

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Medsurety Recurring Dependent Care Request Form

MEDSURITY - Recurring Dependent Care Request Form.pdf 383.71 KB (Last Modified on January 5, 2019)

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Medsurety Ortho Worksheet and Form

MEDSURETY - Ortho Worksheet and Form.pdf 316.25 KB (Last Modified on January 5, 2019)

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Flexible Spending Account Plan Summary

SSP_PlanSummary_Section 125_Medsurety_2019.pdf 722.58 KB (Last Modified on December 4, 2019)

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