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Arlington Central School District

FLEX Benefit Plan Forms

Flex Benefit Open Enrollment Information

Open Enrollment Period

Open enrollment for the Flex Benefit Plan & AFLAC is through September 20, 2024.

FLEX Open Enrollment and info24-25.pdf 111.73 KB (Last Modified on August 26, 2024)

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Flex Benefit Enrollment Form

2024-25 Flex Benefit Enrollment Form. Due by September 20, 2024.

Flex Enrollment Form 2024-25.pdf 232.25 KB (Last Modified on August 26, 2024)

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FLEX Benefits Informational Brochure

flexbenefitsinformationalbrochure.pdf 321.727 KB (Last Modified on June 8, 2018)

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Direct Deposit FLEX Reimbursement

directdepositflexreimbursementform.pdf 121.551 KB (Last Modified on June 8, 2018)

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Reimbursement Voucher (with instructions)

reimbursementvoucher.pdf 52.247 KB (Last Modified on June 8, 2018)

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Allowable Expenses

fsa-allowable-expenses.pdf 90.435 KB (Last Modified on June 8, 2018)

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Eligible Over-the-Counter Expenses

eligibleotcexpenses.pdf 97.408 KB (Last Modified on June 8, 2018)

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