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Home
About
Request for Proposal
Employers
Brokers
Participants
Help

Client Feedback Form

Let us know how your experience with us is going!

Health Accounts Forms

Dependent Care Claim Form (pdf)Download

Universal Claim Form (All Plans Exlc. DCFSA) (pdf)Download

Letter of Medical Necessity (LMN) Form (pdf)Download

HSA Transfer Form (pdf)Download

Plan Handouts

If you are enrolled in an HRA plan, please contact CHS or your employer for your specific handout.

HSA information (pdf)

FSA contribution limits + IRS limitations (pdf)

Employer & Broker Forms

Group Intake Form (pdf)Download

Health Savings Account Enrollment Form (pdf)Download

FSA Enrollment Form (pdf)Download

FSA-LPFSA Enrollment Form (pdf)Download

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