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GENERAL

Universal ApplicationUniversal Employer Application

COBRA

COBRA Set Up PacketDownload PDF
COBRA Initial NotificationDownload PDF

Section 125/FSA

FSA Set Up PacketDownload PDF
ASi ACH FormDownload PDF
Bancorp ACH FormDownload PDF
Premium Only Plan (POP) Set Up PacketDownload PDF
Benny Card Set UpDownload PDF

HRA

HRA Set Up PacketDownload PDF
ASi ACH FormDownload PDF
Bancorp ACH FormDownload PDF
Benny Card Set UpDownload PDF
Enrollment TemplateDownload PDF

MERP

MERP Set Up PacketDownload PDF
EOB Retrieve FormDownload PDF

SF HCSO

SF HCSO Set Up PacketSan Francisco HCSO Compliance Set-Up Form
SF HCSO Quarterly Template Download PDF

Self-Funded Dental/Vision

Self-Funded Dental/Vision Set Up FormDownload PDF
HSA Set-Up FormDownload PDF
HSA Enrollment FormDownload PDF

Section 132/Commuter Benefits

Section 132 Set Up FormDownload PDF
ASi ACH FormDownload PDF
Bancorp ACH FormDownload PDF