Setup Forms
Set Up a New Plan
Set Up Multiple Reimbursement Accounts
Client Information Form (PDF)
Global Banking Form
Enrollment Submission Spreadsheet (XLS)
Payroll Funding Template
For Takeover Balances
Flexible Spending Accounts
Flexible Spending Accounts are allowed special treatment under section 125 of the Internal Revenue Code, Which allows employees a choice between tax-free benefits and cash compensation. Commonly referred to as Cafeteria Plans, Section 125 Plans, POP (premium only) and FSA plans, these plans allow employees to use pre-tax dollars to pay for certain qualified expenses.
Premium Only Plan (POP) Compliance Subscription
Premium Only Plan
POP Client Information Form (PDF)
Set up Flexible Spending Account Plan (FSA)
FSA Client Information Form (PDF)
FSA & Commuter Client Information Form (PDF)
FSA & HRA Client Information Form (PDF)
FSA & HRA & Commuter Client Information Form (PDF)
Health Reimbursement Arrangements
Health Reimbursement Arrangements are employer-funded accounts with the flexibility to customize designs and usage. When combined with group health plans, HRAs are a powerful tool for rewarding and encouraging healthy decisions and behaviors, while keeping premiums costs under control.
HRA Client Information Form (PDF)
HRA & FSA Client Information Form (PDF)
Excepted Benefit (EBHRA) - Client Information Form (PDF)
Individual Coverage HRA (ICHRA) Client Information Form
Lifestyle Accounts
Health Savings Accounts
Health Savings Accounts are employee-owned, tax-favored savings accounts with a qualifying High Deductible Health Plan (HDHP) allowing payment for qualifying healthcare expenses with tax-free dollars.
WealthCare Saver HSA
WealthCare Saver HSA Client Information Form (PDF)
HSA Funding Spreadsheet
Avidia Bank HSA
Avidia Bank HSA Client Information Form
HSA Funding Spreadsheet
COBRA & Direct Premium Billing
COBRA & Direct Premium Billing can be difficult to administer. Just keeping up with the rules and regulations can be a full-time job, and that’s why you should check out American Benefits Group. We make it easy so you can focus on other important tasks.
COBRA & Direct Billing Client Information and Participant Data Workbook
Commuter Transit & Parking Benefits
Section 132 Qualified Transportation Fringe Benefits allow employees (or employers) to pay for commuter transit and parking benefits such as transit passes, commuter highway van pool expenses and qualified parking expenses with pre-tax dollars.
Employers: Benefit Offering or Plan