State of Connecticut Medical Flexible Spending Account

This page was last updated on: January 28, 2020

MEDFLEX Fact Sheet - rev. 2020 (PDF)

Eligible/Ineligible Expenses (PDF)

MEDFLEX FLEXIBLE SPENDING PROGRAM - OPEN ENROLLMENT PLAN YEAR 2020 - CO-1306 (Rev 1/2020) (PDF)

MEDFLEX FLEXIBLE SPENDING PROGRAM - MID-YEAR ENROLLMENT OR STATUS CHANGE - CO-1306A (REV 1/2020) (PDF)

MEDFLEX Claim Reimbursement Form - CO-1307

MEDFLEX Medical Necessity Form Letter - CO-1308

MEDFLEX Capital Expense Form - CO-1309

MEDFLEX 2017 Plan Document  (PDF)

 

MEDICAL FLEXIBLE SPENDING ACCOUNT PROGRAM

Progressive Benefit Solutions (PBS) - Third Party Administrator web site:
 

14 Business Park Drive, #8
Branford, CT 06405
 

Consumer Portal Quick Start Guide

http://www.irs.gov/pub/irs-pdf/p502.pdf

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