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Welcome to BASIC – Northeast Ohio (NEO) Location

Forms & Resources

FSA and Parking Claim Forms

Medical Reimbursement Claim Form

FSA Debit Card-Medical Reimbursement Claim Form

Dependent Care Reimbursement Claim Form

Dependent Care Provider Receipt

Parking Reimbursement Claim Form

FSA/HRA Online Portal Overview

Employer Portal Demo:

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Consumer Portal Demo:

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FSA Forms and Resources

OTC Drugs and Medicines FAQs

Dependent Care FSA Flyer

FSA Eligible and Ineligible Medical Expenses

Debit Card Guidelines

Orthodontia Guidelines

IIAS Merchant List for FSA Debit Card Participants

Visa Terms and Conditions

Using a PIN with your BASIC Benefits Debit Card

FSA Employee Brochure

FSA Debit Card Brochure

FSA Debit Card Brochure (Spanish)

What is Consumer Driven Healthcare (CDH)?

HRA Forms and Resources

To access your employer’s customized HRA Reimbursement Claim Form log in to your online consumer portal.

Health Reimbursement Account (HRA) Brochure
Important Note: Reimbursements for the BASIC NEO location are issued weekly each Wednesday.

Health Reimbursement Account (HRA) Information from Pub 969

Qualified Transportation Accounts (QTA)

Guidelines for Parking and Transit

HSA Forms and Resources

OTC Drugs and Medicines FAQs

HSA Eligible and Ineligible Medical Expenses

Healthcare Bank Terms and Conditions Agreement

HSA User Guide and Welcome Kit

HSA Transfer Form for Individuals

BASIC HSA Guide

COBRA Resources

COBRA Employer Portal Demo: