Additional information about the new Forms and Publications page is available in the Web Team's blog post, Reimagining the Forms and Publications page.
Click a category under 'Forms Navigation' to display a set of forms and publications. Upon making your selection, the forms and publications for that category will appear on the right side of the screen, in place of this text.
To search, begin typing a form name or number in the search field on the left side, beneath the 'Forms Navigation' heading. As you type, search results will appear on the right side of the screen, in place of this text.
The Service Center Web Team recommends using Adobe Reader, a free program, to access the PDF forms listed on this page.
Some benefit plans have employer-only forms in addition to employee forms. To access these, click the 'View Employer Forms' link that appears (if applicable) to the right of the category heading.
Medical Expense Account after termination
If you terminate employment or cease to be an eligible employee prior to the end of the plan year and do not arrange to continue your coverage, your coverage ends at the end of the month in which your last ERA payroll deduction was taken. Expenses for services provided to you after this date are not reimbursable.
Dependent Care Account after termination
If you terminate employment or cease to be an eligible employee prior to the end of the plan year, you cannot continue dependent care contributions. You can continue to request reimbursement for eligible expenses from your Dependent Care Account until you exhaust your account balance or March 15, whichever comes first, even if you have not contributed the full annual amount for which you enrolled. Valid expenses are those that are incurred for the care of a qualified dependent so that you (and your spouse) can work, look for work, or attend school full-time.