BENEFLEX makes enrolling in our flexible spending account as easy and convenient as possible. Simply click on the link for the program your company offers. Complete the application online, sign, print and fax it to our toll free Fax at 800-449-7501. Thank you for choosing Beneflex- where the client is King!
   

Dependent Care FSA Application

Medical FSA Application

Please click here for any other forms you may need.
Please read the terms and regulations so that you are fully aware of your rights and responsibilities.
Beneflex Inc. (800)925-4087