FSA Forms
Here you will find forms pertaining to flexible spending account elections, reimbursements, eligible expenses and moreā¦
FSA Election Form
FSA Claim Form
Continual Reimbursement Form (Dependent Care)
Direct Deposit Authorization
Healthcare FSA Eligible Expense Guide
FSA Participant Login Instructions
Click here to learn more about flexible spending or contact a TAG Flex specialist to find answers to your flexible spending questions.
COBRA Documents
Existing Clients: Please complete the appropriate notification form below and submit to your account service representative for immediate action.
New Groups: Please find below the initial setup documents to establish COBRA services through TAG. An administrative agreement will be supplied for endorsement upon receipt of required company information.
COBRA Administration Application
Carrier and Plan Information*
Current COBRA Participant Takeover Form
Carrier Authorization Letter*
*Carrier & plan information forms and authorization letters are required for each carrier.
Submit New Group Information:
Your Account Manager will contact you to provide administrative details and a timeline of implementation. For immediate assistance please contact a TAG COBRA specialist.