state of connecticut

State of Connecticut
Medical Flexible Spending Account

This page was last updated on: March 12, 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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