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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: www.ebcflex.com/
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
PDF document Caa Covid 19 Relief Changes (96 KB)
PDF document Ebc Claim Form (572 KB)
PDF document Ebc Direct Deposit Form (259 KB)
folder Ebc Guides And Worksheets (9)
folder Eligible Expenses (5)
PDF document Permitted Changes Form (364 KB)
folder Plan Documents (2)
MS Word document Snc Enrollment And Change Forms For Benefits (166 KB)
folder Summary Plan Description

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