Get Ameriflex New Client Application

This guide provides detailed instructions on completing the AmeriFlex New Client Application online. By following these steps, you can ensure all required information is accurately submitted to set up your desired services effectively.

Follow the steps to complete the application seamlessly.

1. Press the ‘Get Form’ button to download the AmeriFlex New Client Application and open it for editing.
2. Begin by selecting the applicable service(s) you wish to request. Options include medical flexible spending account, limited purpose FSA, dependent care FSA, healthcare reimbursement account, health savings account, commuter reimbursement account, COBRA administration, or a premium-only plan. Complete sections 1-4 as specified for each service you select.
3. Provide your employer information in the designated section. Include the legal name, telephone, fax, mailing address, and the state and ZIP code. Make sure to specify the contact persons for various invoicing and administrative needs.
4. Fill out the fees and administration section accurately, detailing any setup fees and monthly administration fees related to the services you are applying for.
5. If applicable, disclose agent or broker information, including their contact details and federal tax ID number. Indicate if they referred you to AmeriFlex.
6. Complete the cafeteria plan information if you are applying for specific components like MFSA, DCFSA, LPFSA, or a premium-only plan, ensuring all necessary dates and requirements are filled in.
7. Finally, review all entered information carefully. Once confirmed, you may proceed to save your changes, download, print, or share the completed form as needed.

Begin your online application today to experience the benefits of AmeriFlex services.