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NC Office of Human Resources »  
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NCFlex Flexible Spending Account Documents

Files

2021 NCFlex FSA Claims Kit_updated with CAA.pdf

PDF • 258.27 KB - March 19, 2021

NCFlex Sample List of FSA Eligible Expenses.pdf

PDF • 131.39 KB - April 05, 2021

FSA_Eligibility_List-by-FSAStore.com_.pdf

FSA Eligibility List by FSAStore com

PDF • 8.08 MB - October 13, 2020
Flexible Spending Account, Dependent Day Care, Claim Forms

NCFlex FSA Claim Form.pdf

NCFlex FSA Claim Form

PDF • 196.21 KB - November 29, 2017
Flexible Spending Account, Dependent Day Care, Claim Forms

NCFlex-Letter-of-Medical-Necessity-Form_2020.pdf

NCFlex Letter of Medical Necessity Form 2020

PDF • 150.81 KB - April 29, 2020
Flexible Spending Account, Dependent Day Care, Claim Forms

NCFlex FSA FAQs 2021_updated with CAA provisions.pdf

PDF • 1.11 MB - March 19, 2021

NCFlex FSA Cheat Sheet 2021_updated with CAA.pdf

PDF • 322.88 KB - April 05, 2021

2021-HCFSA-Details.pdf

2021 HCFSA Details

PDF • 90.68 KB - December 07, 2020
Flexible Spending Account, Dependent Day Care, Claim Forms

2021-DDCFSA-Details.pdf

2021 DDCFSA Details

PDF • 84.31 KB - December 07, 2020
Flexible Spending Account, Dependent Day Care, Claim Forms

2021-FSA-Convenience-Card-Details.pdf

2021 FSA Convenience Card Details

PDF • 65.84 KB - December 07, 2020
Flexible Spending Account, Dependent Day Care, Claim Forms

Claim-Submission-Online-FSA-How-To.pdf

Claim Submission Online FSA How To

PDF • 145.56 KB - December 07, 2020
Flexible Spending Account, Dependent Day Care, Claim Forms

Claim-Submission-via-Mobile-Device-FSA-How-To.pdf

Claim Submission via Mobile Device FSA How To

PDF • 357.23 KB - December 07, 2020
Flexible Spending Account, Dependent Day Care, Claim Forms

PandA-Mobile-App-for-State-of-North-Carolina.pdf

PandA Mobile App for State of North Carolina

PDF • 978.81 KB - September 23, 2019
Flexible Spending Account, Dependent Day Care, Claim Forms

NCFlex-HIPAA-Authorization-Form.pdf

NCFlex HIPAA Authorization Form

PDF • 122.73 KB - December 11, 2019
Flexible Spending Account, Dependent Day Care, Claim Forms

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North Carolina Office of State Human Resources

Mailing Address: MSC 1331, Raleigh, NC 27699-1331
Physical Address: 116 W. Jones Street, Raleigh, NC 27603

984-236-0800

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https://oshr.nc.gov/ncflex-flexible-spending-account-documents