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SUFFOLK County

 

 

Flexible Benefits
Why Flex?
Enrollment Instructions
Forms
FAQ
Summary Plan Description

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Suffolk County - Pre-Tax Flexible Benefit Program

Suffolk 2010 Annual Flexible Benefits Enrollment
is closed at this time

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START HERE (Enrollment Instructions)

Use documents and forms below to learn about and participate in a Flexible Benefits program.

PDF's require the Adobe Acrobat Reader Plug-In. Get Acrobat Reader
 
interactive FORMS printable
  Summary Plan Description (PDF)
(on-line) 2010 Flexible Benefits Enrollment Form (PDF)
  Confidential Flex Spending Worksheet (PDF)
(on-line) Calculate Your Flexible Benefits Savings Potential  
    HIPAA NOTICE REGARDING CLIENT PRIVACY (PDF)
Questions And Answers (PDF)
  Dependent Care Assistance Program Registration Statement (PDF)
  Dependent Care Reimbursement Calendar - 2009 (PDF)
  Dependent Care Reimbursement Calendar - 2010 (PDF)
  Examples Of Expenses Eligible For Reimbursement (PDF)
  Flex Plan Change Form (PDF)
  Claims Reimbursement FAQ (PDF)
(on-line)     Flexible Benefits Reimbursement Voucher (PDF)
  Flex Reimbursement Procedures (PDF)
    FSA Letter of Medical Necessity (PDF)
Direct Deposit Authorization (PDF)
  Lost Check and Replacement Form.pdf (PDF)
    IMPORTANT NOTICE REGARDING CLIENT PRIVACY (PDF)

 

 
flexbene.com
PO Box 587
Pittsford, NY 14534
(585) 385-6010
(800) 836-8100
Fax: (585) 248-2488
info@flexbene.com
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