FEBCO Your Road to
Reducing Cost and Enhancing Value
in Benefits Administration
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Agent Forms

 

 Enrollment Form

  Use this form to enroll a new or renewing participant.

 Qualified Status Change Form

 Change of Address Form

  Use this form to change a participants email, telephone number, and/or mailing address. 

 Termination of Employee Form

 Additional Febco Card Request Form

  Use this form to request any additional Febco Benefits MasterCards for the participant and/or dependents.