If paying setup fee by credit card, you are required to also submit this credit card payment form.

Each employee must complete which includes the business owner/sole proprietor

For companies that wish to pre-fund their FlexSave plan on a monthly basis

For companies that wish to pay stop/loss insurance on a monthly basis

Each applicable employee must complete along with business owner

Complete this form to make any changes to the company or an individual employee

Complete this form to remove an employee from the FlexSave plan

For existing FlexSave clients to add a Wellness Plan to their account