Flexible Spending Account (FSA)

Plan Summary

Eligibility:

All full-time employees who work at least twenty (20) hours per week are eligible for coverage the first of the month following their date of hire.

 


Benefit Forms

Claim Form

Direct Deposit Request Form

Change of Status Form

PIN Info Q&A

First Time NBS Portal Log In Instructions

2019-2020 Benefit Forms

FSA Plan Highlights

FSA Login Instructions

FSA Direct Deposit Form

FSA Claims Reimbursement Request Form

FSA Quick Reference Guide

FSA – How it works – Tax Example

FSA Store Coupon Flyer

FSA Reference Brochure

FSA Eligible and Ineligible Expenses

FSA Online Store Website

MyFSA Express Mobile App Registration

Available on the App Store and Google Play

Access your account to check your balance and to view processed claims.
Remember to Fax all claims to: 1-253-793-3766

Helpful Resources

Carrier Customer Service
1-877-837-5017

E-Mail: help@mybenefitexpress.com

Employer ID: BEXHAYS

Website: MyFSA Express

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