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Flex Spending Account, A State employee benefit that puts money in your pocket
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NYS Flex Spending Account 2010 Forms


SUBMIT YOUR CLAIMS ONLINE
You can now submit your reimbursement requests online through myFBMC.com. This process allows you to submit, via FBMC’s secure website, a scanned image of your completed claim form along with scans of your supporting documentation.

First time users should follow the instructions to complete the New Users registration process. After you have registered at myFBMC.com, logon, click on the Claims tab, then select "Online FSA Claim Submission" from the drop down box.



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HEALTH CARE SPENDING ACCOUNT FORMS
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  • Letter Of Medical Need Form
  • HCSA Reimbursement Request Form and Instructions (PDF VERSION) (FILL-IN FORM VERSION)
  • Personal Use Items/Special Foods Form
  • Capital Expenditure Worksheet
  • HCSA Tax Calculator


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    DEPENDENT CARE ADVANTAGE ACCOUNT FORMS
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  • NYS Network Child Care Centers Listing
  • DCAA Tax Calculator
  • DCAA Reimbursement Request Form (PDF VERSION) (FILL-IN FORM VERSION)
  • DCAA Reimbursement Request Form Instructions (PDF VERSION)


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    OTHER FORMS
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  • Enter The RACE (Direct Deposit) Form (PDF VERSION)


  • This Page Last Updated: Tuesday, September 08, 2009 at 6:59:06 PM

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