Employer & Broker Resource Center

Submit Request

Request Proposal
Submit Enrollment
Submit Election Change
Submit Termination
Company Name/Address Change
Add/Remove Authorized Contact

Forms & Downloads

Client Applications

HRA Client Application
Flex Client Application (non-HRA plans)
COBRA Client Application
COBRA Rate Renewal Form
POP Client Application
WRAP Doc Application

Non-Discrimination Testing Templates

Section 105 - HRA Template
Section 125 - Flex Template

Funding

ACH Account Change Form

Enrollment Templates

HRA Enrollment Template
Flex Enrollment Template (non-HRA plans)
COBRA New Hire/QLE Template

Enrollment Flyers

FSA (no option)
FSA (rollover)
FSA (2.5 grace period)
DCA (no option)
DCA (2.5 grace period)
Commuter
HSA
Limited FSA
View More

How To Videos

Watch Posting HSA Deposits (Contribution Manager - UI Tool) videoplay video
Posting HSA Deposits (Contribution Manager - UI Tool)
Watch Posting HSA Deposits (Contribution Manager - File Uploads) videoplay video
Posting HSA Deposits (Contribution Manager - File Uploads)
Watch Registering online (for participants) videoplay video
Registering online (for participants)