Flexible Spending Account (F.S.A.) Forms and Information

A Flexible Spending Account is a special account you deduct pretax money from your pay check to use to pay for eligible out-of-pocket health care costs such as office visit co pays, deductibles or prescription co pays.

Flexible Spending Account Brochure 2017

How To Submit Claims

Flex Administrators F.S.A. FAQ

FSA Reimbursable and Unreimbursable Expense List

IRS Publication 502 (Complete List)

FSA Reimbursement Form (Health and Dependent Care)

Flex Dependent Care Mandatory Statement

FSA Direct Deposit Form and Instructions

FSA  Use it or Lose it ... Not Anymore!!

My Source Card FSA Debit Card


If you do not find the information you are looking for please contact the HR Benefit Department.