FSA FLEX Services for AmFamFit Employees

FSA Medical Spending Account

Use this Form to enroll in an Annual Medical Spending Account.

Premium Only Enrollment Form

Use this Form to Authorize Pre-Tax Deductions for Group Premiums to be Payroll deducted.

FSA Dependent Care Account

Use this Form to enroll in an Annual Dependent Care Spending Account.
These Forms are intended to be printed, completed, and forwarded to:
FLEX@MoneyWiseSolutions.com or FAXed to 888.994.9394
so they can be loaded into the claims system.