Wage Works – FSA

As of January 1, 2004, Wage Works has replaced the EBPA Flexible Spending program. Please use your Wage Works debit card to pay for expenses (this is the preferred method) OR visit their Web site for reimbursement forms and instructions. Reimbursement forms may also be obtained by calling the number below.

Provider Information for submitting claims:

WageWorks Processing Center
4129 E. Van Buren St., Suite 220A
Phoenix, AZ 85008
Fax: (610) 263-0027

Ph: (877) 924-3967
Web site: www.wageworks.com

Forms:

Dependent Care Pay Me Back Claim Form (PDF)

Health Care Pay Me Back Claim Form (PDF)

USNH Flexible Benefits Policy