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DCA - Dependent Care Reimbursement Account

 

 Dependent Care Acknowledgement Form

 If you will not be using your Benefit card to pay your Dependent care provider, have your provider complete this form to be reimbursed.

 

 

FSA - Flexible Spending Account

 

 List of FSA eligible item and expenses

  The information on this list is general, it may be updated without notice. If any information conflicts

 with your employer's plan documents, your employer's plan documents will govern.