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Employer Forms


 Enrollment Form

  Use this form to enroll a new or renewing employee.

 Qualified Status Change Form
 Termination of Employee Form

 Change of Address Form

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

 Additional Febco Card Request Form

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

 Debit Card Acknowledgement Form