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Click ‘Get Form’ to open the paychex form fsa003 in the editor.
Begin by filling out the EMPLOYEE INFORMATION section. Enter your name, company name, last four digits of your Social Security Number, telephone number, and email address. Ensure all information is accurate for smooth processing.
In the CLAIM INFORMATION section, certify that the details provided are true and correct. This includes confirming that expenses were incurred for yourself, spouse, or dependents and are not reimbursable under any other health plan.
For each service claim, provide the service recipient's name, relationship to you (self, spouse, or dependent), service date(s), description of service (medical, dental, vision, pharmacy), provider's name, and amount. Repeat this for additional claims as necessary.
After completing all sections, sign and date the form. You can then fax it to the provided number or mail it to Paychex’s address for processing.
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Paychex offers customizable FSAs tailored to your needs, providing flexibility in managing expenses and maximizing savings.
Does Paychex offer an FSA?
Flexible Spending Account (FSA) Benefits From Paychex. Offer a Paychex FSA to your team to elevate your health benefits while achieving cost-savings.
What are Paychex Flex perks for employees?
Help employees feel valued and supported with our lifestyle benefits marketplace featuring products and services for happier, healthier lives, including financial fitness programs, supplemental insurance, entertainment discounts, and more all at no additional cost to you.
How to get tax forms from Paychex?
Log in to Paychex Flex. Under Tax Documents, click the PDF icon to download your W-2 or 1099.
Does every employer offer FSA?
Most employers can offer an FSA, with a few exceptions. You may want to check with your legal or tax advisor regarding your special situation.
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Is there a difference between Paychex and Paychex Flex?
Follow these instructions: Log into paychexflex.com and select My Retirement. Select Distributions. View your available options and request a distribution.
Does Paychex offer HSA?
Paychex Flex, our all-in-one platform, allows employees to initiate various HSA activities themselves, such as viewing health plan information, enrolling in an HSA, payroll deduction selection, and more.
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