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Flex Spending Account Benefit
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Below you find the following flex spending account benefit plan documents for the Archdiocesan Flexible Spending Account Benefit. Completed forms should be submitted to your human resources / business office representative.
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Flexible Spending Benefit - UMR
- 2025 FSA Plan Enrollment Form
- 2024 Flex Plan Enrollment Form
- FSA Employee Guide
- UMR FSA Mobile App
- Flex Eligible and NonEligible Expenses
- Letter of Medical/Dental Necessity
- Flex Spending Acct Flyer
- Flexible Spending Claim Form - Health FSA
- Flexible Spending Account Claim Form - Dependent Care FSA
- Flex Change Form
- Flex Automatic Reimbursement Opt Out Form
- Flex Plan Document 2022