Forms and Resources

• COBRA
• FSAs
• HRAs
• Transportation Assistance

COBRA

• Initial DOL Notification Request
• COBRA Qualifying Event Notification
• Direct Deposit Form
• COBRA Administrator’s Guidebook

FSAs

• FSA Enrollment & Change Form
• Dependent Care Claim Form
• Health Care Claim Form
• Direct Deposit Form
• Dependent Debit Card Request Form
• IIAS Participating Merchant List - As of July 1, 2009 this is an up to date IIAS compliant Merchant list. Please keep in mind this list is constantly updated, to find the most up to date information please visit www.sig-is.org
• Calculate Tax Savings

HRAs

• HRA Enrollment & Change Form
• HRA Claim Form
• Direct Deposit Form
• Dependent Debit Card Request Form

Transportation Assistance

• Parking and Transit Enrollment Form
• Transportation Claim Form
• Bicycle Commuting Claim Form
• Direct Deposit Form