FSA

FLEXIBLE SPENDING ACCOUNTS
United Healthcare (FSA) Group #: 709593 OR 708611 Contact: (800) 510-4846 Website: www.myUHC.com Flexible Spending Account(FSA)-Summary Plan Description(SPD) Flexible Spending Account(FAQ'S) Health Care FSA Worksheet Dependent Care FSA Worksheet Over-the-Counter (OTC) Drug List: qualified as expenses under the Health FSA account	FORMS AND BILLING
	Flexible Spending Account Enrollment Form 0910: for both Health and Dependent Care Accounts (PY 09/10) FSA-UHC Claim Form Important Deadline for FSA claims submission: PY 09/10 - September 30, 2010* PY 10/11 - September 30, 2011* *Terminated employees must submit FSA claim form within 90 days from the last day of coverage. FSA UHC Direct Deposit Request Form

Last Updated: Wednesday, October 7, 2009 at 4:19:12 PM
©2009 Foothill-De Anza Community College District