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  • Ameriflex Cobra Open Enrollment Form 2023

Get Ameriflex Cobra Open Enrollment Form 2023-2025

COBRA Open Enrollment Form Date:Company Name: Applicant Name(first, middle, last):Member ID (which may be your SSN): Address: State:City: Gender: MFDOB:Zip+4: Marital Status: SingleTel: MarriedEmail:HRA.

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2023 Benefit Guide
Our benefits program will help you choose what works best for your needs and your budget...
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COBRA Open Enrollment Form
DEPENDENT COVERAGE: Son Daughter. Applicant Name (first, middle, last): Address (if...
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JULY 01, 2020 THROUGH JUNE 30, 2023 CONTRACT ...
Feb 25, 2020 — ASI COBRA will assist with open enrollment and process open enrollment...
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Through your online account and Ameriflex mobile app, you can check your balance, reimburse yourself for out-of-pocket spending, check the status of a claim, set up direct deposit, and more.

Order a replacement card From your Ameriflex app, go to Menu > Debit Card. Select family member whose card is being replaced. Tap Report Card as Lost or Stolen and Issue Replacement. Check to make sure the address listed is correct, then tap Confirm Replacement.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 requires employers with 20 or more employees who provide healthcare benefits to offer the option of continuing this coverage to individuals who would otherwise lose their benefits due to termination of employment.

Open enrollment isn't just for your active employees. Your COBRA members also go through an open enrollment period each year.

HRAs are funded by the employer to help offset out-of-pocket healthcare costs. Funds are tax-free for the employer and employee. Employees will receive an Ameriflex Debit Mastercard® linked to their HRA. Employees can use their card for eligible purchases everywhere Mastercard® is accepted.

Questions? To learn more about how you can easily manage your healthcare benefit account from your mobile phone, contact Ameriflex at 888.868. 3539 or visit myameriflex.com.

Employees can save up to 40% on thousands of eligible everyday expenses such as prescriptions, doctor's visits, dental services, glasses, over-the-counter medicines, and copays. Every dollar an employee contributes to an FSA lowers their taxable income.

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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
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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