For your convenience, a link to the CBIZ Flexible Spending Account Enrollment Brochure is provided. (CBIZ FSA Enrollment Brochure)Use this link: CBIZ Flex Flexible Benefits Plan Claim Form to access the claim form to request reimbursement for medical expenses or dependent care.
Complete the form in its entirety.1. Complete the worksheet on the back of this form to itemize expenses and attach original receipts.
2. This completed form and all required attachments should be mailed to:
CBIZ Payroll, Attn: Flex2797 Frontage RoadSuite 2000Roanoke, VA 24017Fax #1-800-584-4185Phone: #1-800-815-3023, Option 4Email: email@example.com