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Get Diversified Benefit Services

DI ERSIFIED BENEFIT SER ICES, INC. Dedicated to Excellence in Benefit Management Solutions 105-HRA Mail or fax this form with documentation to: Diversified Benefit Services, Inc. P.O. Box 260 Hartland,.

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Flexible, tax-free and so easy to use. Eligible employees determine the amount they want to contribute to their Health Care FSA or Dependent Care FSA. The amount chosen by employees is automatically deducted pre-tax (meaning before FICA, federal and state taxes) from each paycheck during the plan year.

How do participants know how much is in their account? They can visit the DBS website and view their account activity and current balance. Or, they can call DBS at the 800-234-1229 to obtain their current balance. Participants should always know their account balance before making a purchase with the Card.

A HRA is an employer funded account used to reimburse a portion of your out-of-pocket health care, dental or vision expenses. HRAs are designed to help make your health care more affordable and to lessen your out-of-pocket expenses.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232