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Human Resources Documents and Forms

HR Documents » Medical Dental Flexible Spending » Flexible Spending Account
Flexible Spending Account (FSA) — EBC

You can use the website to print claim forms for submission, view your account balance, and view previously submitted expenses.

Web site:
Customer Service: 1-800-346-2126
Claims Fax #'s: 608-831-4790
Claims Mail Address: Employee Benefits Corporation
P.O. Box 44347
Madison, WI 53744-4347
MS Word document 2018 Employee Open Enrollment Memo (56 KB)
PDF document EBC Claim Form (233 KB)
PDF document EBC Enrollment Form (209 KB)
folder EBC Guides and Worksheets (12)
folder Eligible Expenses (2)
folder Summary Plan Description (2)

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