Reimbursement Account Information for Members
Allegiance offers third party administration of Flexible Benefits Plans (FSAs), Health Reimbursement Arrangements (HRAs), Health Savings Accounts (HSAs), and qualified transportation plans (Parking and Mass Transit). We place priority on accurately processing claims and reimbursing members promptly.
- Health FSA Reimbursement Request Form
- Orthodontic Expense Form
- Dependent Care FSA Reimbursement Request Form
- Daycare Reimbursement Contract
- Limited Purpose Reimbursement Request Form
- Mass Transportation Reimbursement Request Form
- Parking Expense Reimbursement Request Form
- HRA Claim Form / Expenses
- HRA Claim Form / Deductible Expenses
Reimbursement Account Information for Employers
Allegiance offers third party administration of Flexible Benefits Plans (FSAs), Health Reimbursement Arrangements (HRAs), Health Savings Accounts (HSAs), and qualified transportation plans (Parking and Mass Transit). We place priority on accurately processing claims and reimbursing members promptly.
- Health FSA Reimbursement Request Form
- Orthodontic Expense Form
- Dependent Care FSA Reimbursement Request Form
- Limited Purpose Reimbursement Request Form
- Daycare Reimbursement Contract
- Mass Transportation Reimbursement Request Form
- Parking Expense Reimbursement Request Form
- HRA Claim Form / Expenses
- HRA Claim Form / Deductible Expenses
Reimbursement Account Information for Brokers
Allegiance offers third party administration of Flexible Benefits Plans (FSAs), Health Reimbursement Arrangements (HRAs), Health Savings Accounts (HSAs), and qualified transportation plans (Parking and Mass Transit). We place priority on accurately processing claims and reimbursing members promptly.