FSA Details

FSAs Forms / Resources Debit Card Eligible Expenses Calculate Tax Savings FAQs Contact Home

Forms

For your convenience, we’ve posted some forms that you may need in your day-to-day transactions with us. If your browser is set up to use Acrobat Reader, simply click on one of the links below to download a copy of the form.

• FSA Enrollment & Election Change Form
• Health Care Claim Form
• Debit Card Receipt Form
• Dependent Care Claim Form
  
• Direct Deposit Authorization Form
  
• Spousal Debit Card Request Form

Resources

Below you will find plan manuals and handouts to help you make the most of your Flexible Spending Account.

• FSA Employee Handbook (Temporarily unavailable as we upgrade our online services)
  
• FSA Administrator's Guidebook (Temporarily unavailable as we upgrade our online services)
• Eligible Expense List Handout
• IIAS Debit Card Receipt Handout
• FSA FAQ Handout
• Using Your Debit Card Handout

General Information

Customer Service:
Toll free number: 800-371-7542
Fax: 401-457-7266
E-mail: Flexplan@altusbenefitadmin.com

Send claims and all correspondence to:
Altus Benefit Administrators
PO Box 1643
Providence, RI 02901-1643

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