Innovative Employee Benefits, Inc.
Innovative Employee Benefits, Inc.
6926 Shannon Willow Road, Suite 100
Charlotte, NC 28226
PO Box 470257
Charlotte, NC 28247-0257
Phone: 704-341-5981
Email: info@better-benefits.com
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    • Cafeteria Plan
    • Full Flex Plan
    • FSA
    • Limited Purpose Flex Plan
    • QTP
    • HRA
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Forms

Claim Forms

Flex Claim Form
 
Enrollment Forms

Flex Enrollment Form
 
Informational Forms

Flex Enrollment Brochure

 

 

Employer Forms

FLEX PARTICIPANT CHANGE FORM
HRA Claim Form   QTP Enrollment Form   OTC Effective 1/1/2011   ENROLLEE CHANGE FORM
QTP Claim Form   Flex Enrollment Form with PRM   Qualifying Medical Care Expenses  

Section 125 Discrimination Test

Limited Purpose Flex Claim Form   Change of Address Form   Medical Expense Worksheet  

Section 129 Discrimination Test

Flex Claim Form with PRM  

HIPAA Privacy Release Authorization Form

  Dependent Care FSA Worksheet    
    Appeals Request for Review Form   Qualifying Dependent Care Expenses    
       

HIPAA Privacy Procedures

   
             
             
             

Forms must be signed in pen and faxed to: 704-341-5984.

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