At ASi we strive to ensure all of our clients receive up-to-date employer forms. They are all available to print at your convenience. If you are unable to find a form you use regularly, please do not hesitate to contact us. We are here to service your company’s needs and will send you the requested form in a timely manner.

Dental

Central Valley Dental Partners directoryDownload PDF
Mid-Coast Dentistry directoryDownload PDF
Central Coast Dentistry directoryDownload PDF
Southern California Dentistry directoryDownload PDF

Flexible Spending Arrangements (FSA)

Change of StatusDownload PDF
Employee Enrollment AuthorizationDownload PDF
Claims ProceduresDownload PDF
Reimbursement RequestDownload PDF
Sample Expenses Eligible for ReimbursementDownload PDF
Claims Contact ListDownload PDF
FAQs about FSAsOpen URL
FSA CalculatorOpen URL
FSA Eligible ProductsOpen URL

Health Reimbursement Arrangements (HRA)

Employee Enrollment / Change FormDownload PDF
Reimbursement Request FormDownload PDF
Claims ProceduresDownload PDF
Claims Contact ListDownload PDF

Medical Expense Reimbursement Plan (MERP)

Authorization ReleaseDownload PDF
Claims Procedures (How a Claim is Paid)Download PDF
Employee Enrollment / Change FormDownload PDF
Health Insurance WaiverDownload PDF
Reimbursement Request FormDownload PDF
Claims Contact ListDownload PDF

San Francisco HCSO

OLSE Workplace PosterDownload PDF
Claims ProceduresDownload PDF
Reimbursement Request FormDownload PDF
SF HRA Contact ListDownload PDF
Waiver FormDownload PDF