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Simple. Effortless. Efficient.

Whether you need to get set-up or file a claim, download the form that fits and we’ll take it from there.

Health & Welfare Forms & Flyers

Below, you’ll find resources for various employee benefits. Click on the topics to see a list of PDF links to view or download.

The NBS Web Portal

Material for First Time Login

First Time Login NBS Web Portal EID
Spanish First Time Login NBS Web Portal EID
First Time Login NBS Web Portal SSN
Spanish First Time Login NBS Web Portal SSN

The NBS Mobile App

Material for the NBS Mobile App

Mobile App
Spanish Mobile App

The NBS Smart Card (Debit Card)

Material for the NBS Smart Card (Debit Card)

NBS Smart Card
Spanish NBS Smart Card

Flexible Spending Account (FSA)

Material for Flexible Spending Account (FSA)

What is an FSA Brochure
Spanish What is an FSA Brochure
FSA Sample Expenses
Spanish FSA Sample Expenses
Helping Employees Choose FSA or HSA

FSA Forms & Worksheets

FSA Claim Form
Spanish FSA Claim Form
Orthodontic Continual Reimbursement Form
Health Care Expense Worksheet
Spanish Health Care Expense Worksheet
Change of Status Form
Letter of Medical Necessity Form

FSA – Dependent Care (DCAP)

Material for DCAP

What is DCAP Flyer
Spanish What is DCAP Flyer

Dependent Care Forms

DCAP Change of Status Form
Continual Reimbursement Form DCAP Packet
DCAP Change of Status Form
Dependent Care Receipt

Health Spending Account (HSA)

Material for Health Spending Account (HSA)

HSA Employee Welcome Guide
HSA Brochure
HSA Employee FAQ
Helping Employers Choose FSA or HSA

HSA Forms

HSA Distribution of Excess or Mistaken Contribution Form
HSA Transfer of Assets Form
HSA Beneficiary Form

Service Center Information

IRS Publication 969 Health Savings Accounts and Other Tax-Favored Health Plans