▢ Dependent Day Care Eligible Reimbursement Expenses

▢ *ONLINE* Flex Reimbursement Voucher

▢ 2024 Dependent Day Care Calendar

▢ 2023 Dependent Day Care Calendar

▢ Generic Babysitter Receipt

▢ *ONLINE* Dependent Day Care Registration Statement

▢ *Printable* Dependent Day Care Registration Statement

** Dependent Day Care Registration Statement is REQUIRED to be on file each Plan Year in order for Dependent Day Care reimbursement claims to be reimbursed. **
** Dependent Day Care Registration Statement is not considered an ENROLLMENT form **

Procedures & Guidance:

▢ Add Flexbene Shortcut To Your Cell Phone Homescreen!

▢ How To Submit: Flex Reimbursement Claim

▢ FSA Eligible Reimbursement Expenses

Submit a Reimbursement Claim:

▢ *ONLINE* Flex Reimbursement Claim Form

▢     *Printable* Flex Reimbursement Claim Form

▢ Flex Plan Change of Status Form

▢ Flex Plan Change of Status Guidelines