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Flexible Spending Accounts (EBC)

Healthcare & Dependent Care FSA (.pdf forms)

EBC_FLEX_Enrollment_Form.pdfFSA Enrollment Form - 2014FSA Enrollment Form - 2014/www.udmercy.edu/hr/benefits/flex/pdf/EBC_FLEX_Enrollment_Form.pdf212972FSA_Brochure.pdfFSA BrochureFSA Brochure/www.udmercy.edu/hr/benefits/flex/pdf/FSA_Brochure.pdf837046UDM_FSA_Debit_Card_FAQ.pdfFSA FAQ 2014FSA FAQ 2014/www.udmercy.edu/hr/benefits/flex/pdf/UDM_FSA_Debit_Card_FAQ.pdf84546FSA_Understanding_of_Agreements.pdfUnderstanding of AgreementUnderstanding of Agreement/www.udmercy.edu/hr/benefits/flex/pdf/FSA_Understanding_of_Agreements.pdf22280EBC_Summary_Plan_Description.pdfFSA Summary Plan DescriptionFSA Summary Plan Description/www.udmercy.edu/hr/benefits/flex/pdf/EBC_Summary_Plan_Description.pdf72527EBC_FLEX_Online_Instructions.pdfOnline InstructionsOnline Instructions/www.udmercy.edu/hr/benefits/flex/pdf/EBC_FLEX_Online_Instructions.pdf25468FSA_Qualified_Expenses.pdfQualified Medical ExpensesQualified Medical Expenses/www.udmercy.edu/hr/benefits/flex/pdf/FSA_Qualified_Expenses.pdf51116EBC_Qualified_Daycare_Expenses_2011.pdfQualified Daycare ExpensesQualified Daycare Expenses/www.udmercy.edu/hr/benefits/flex/pdf/EBC_Qualified_Daycare_Expenses_2011.pdf30804EBC_Qualified_Elder_Care_Expenses_2011.pdfQualified Elder Care ExpensesQualified Elder Care Expenses/www.udmercy.edu/hr/benefits/flex/pdf/EBC_Qualified_Elder_Care_Expenses_2011.pdf30192EBC_FLEX_Medical_Claim_Form.pdfMedical Claim FormMedical Claim Form/www.udmercy.edu/hr/benefits/flex/pdf/EBC_FLEX_Medical_Claim_Form.pdf304895EBC_Dependent_Care_Claim_Form.pdfDependent Care Claim FormDependent Care Claim Form/www.udmercy.edu/hr/benefits/flex/pdf/EBC_Dependent_Care_Claim_Form.pdf308964/www.udmercy.edu/hr/benefits/flex/pdf/formsforms