Submit a request – Forma Admins

Your email address

Subject

Client Name

Requester Name

Requester's email address

I would like to end the LSA program(s).(optional)

Toggle on the checkbox if you have LSA program(s) to end. Corresponding questions will show to collect necessary information.

I would like to end the HRA program(s).(optional)

Toggle on the checkbox if you have HRA program(s) to end. Corresponding questions will show to collect necessary information.

I would like to end the FSA/LPFSA plan.(optional)

Toggle on the checkbox if you have FSA/LPFSA plans to end. Corresponding questions will show to collect necessary information.

I would like to end the DCFSA plan.(optional)

Toggle on the checkbox if you have DCFSA plans to end. Corresponding questions will show to collect necessary information.

I would like to end the HSA plan.(optional)

Toggle on the checkbox if you have HSA plans to end. Corresponding questions will show to collect necessary information.

I would like to end the Commuter plan.(optional)

Toggle on the checkbox if you have commuter plans to end. Corresponding questions will show to collect necessary information.

When is the contract end date for the HRA/LSA programs?

The contract end date must be at least 2 months after the submission of this request.

When is the contract end date for the pretax plans (FSA/HSA/Commuter)?

[LSA] When is the program end date for the LSA program(s)?

This date must be at least 1 month after the submission of this request. The program end date refers to the last day when members can utilize the program(s) including filing reimbursement claims, purchasing on Forma store, using Forma cards, and linking bank accounts. If you wish to extend the program end date beyond the contract end date, an amendment is required. For confirmation on the amendment process, please contact your Customer Success Manager at Forma.

[LSA] When is the date to communicate the program end date with employees?

The date you would like Forma to update the Program Policy to reflect the program end date and last day to submit claims or use Forma Store/ Card.

[LSA] When would you like to receive the final payroll report(s)?

Please note that Forma will need 5 days to compile the report(s) after the program end date.

[LSA] Are you using Direct Deposit to receive reimbursements? (optional)(optional)

[LSA] Do you need a one-off report for the claims that have not been paid out? (Optional)(optional)

[HRA] When is the program end date for the HRA program(s)?

This date must be at least 1 month after the submission of this request. The program end date refers to the last day when members can utilize the program(s) including filing reimbursement claims and linking bank accounts. If you wish to extend the program end date beyond the contract end date, an amendment is required. For confirmation on the amendment process, please contact your Customer Success Manager at Forma.

[HRA] When is the date to communicate the program end date with employees?

The date you would like Forma to update the Program Policy to reflect the program end date and last day to submit claims.

[HRA] When would you like to receive the final payroll report(s)?

Please note that Forma will need 5 days to compile the report(s) after the program end date.

[HRA] Are you using Direct Deposit to receive reimbursements? (optional)(optional)

(HRA) Do you need a one-off report for the claims that have not been paid out? (Optional)(optional)

Do you need Forma to host the runout period or grace period for the FSA/LPFSA plan? (optional)(optional)

If you choose not to have the runout period or grace period with Forma, Forma will provide a report with the full rollover amount after the plan ends. The potential risk for not having the runout period or grace period with Forma is that the new administrator may refuse to administer the contributions before their contract starts.

Do you want to change the runout period or grace period setting for the FSA/LPFSA plan per off-boarding? (optional)(optional)

If yes, please check the box and provide the new runout period or grace period in the description session. If this box is not checked, Forma will set up account runout period/grace period per Open Enrollment documents.

Do you need Forma to host the runout period or grace period for the DCFSA plan? (optional)(optional)

If you choose not to have the runout period or grace period with Forma, Forma will provide a balance forfeiture with the full account balance after the plan ends. The potential risk for not having the runout period or grace period with Forma is that the new administrator may refuse to administer the contributions before their contract starts.

Do you want to change the runout period or grace period setting for the DCFSA plan per off-boarding? (optional)(optional)

If yes, please check the box and provide the new runout period or grace period in the description session. If this box is not checked, Forma will set up account runout period/grace period per Open Enrollment documents.

Do you need Forma to host the runout period or grace period for the Commuter plan? (optional)(optional)

If you choose not to have the runout period or grace period with Forma, Forma will provide a balance forfeiture with the full account balance after the plan ends. The potential risk for not having the runout period or grace period with Forma is that the new administrator may refuse to administer the contributions before their contract starts.

When is the end date of Commuter runout period?

Do you want to initiate HSA bulk transfer? (optional)(optional)

When is the HSA bulk transfer target date? (optional)

Please note that this is the proposed date from the client. The finalized date will be decided and informed by Forma.

Description

Please enter the details of your request. A member of our support staff will respond as soon as possible. ** Zendesk is HIPAA/GDPR compliant, please rest assured to include employee information in your requests. **

Attachments(optional)

Add file or drop files here