Please note that accounts inactive for more than 24 months are deactivated as a security precaution. If your account has been deactivated, please create a new account; all prior data will be available through this new account.
Allegiance offers third-party administration of Flexible Benefits Plans (FSAs), Health Reimbursement Arrangements (HRAs), Health Savings Accounts (HSAs), and qualified transportation plans (Parking and Mass Transit). We place priority on accurately processing claims and reimbursing members promptly.
Reimbursement Account Resources
Reimbursement Account Information
- Debit Card Information
- Limited FSA Expenses
- HSA Advantage
- Flex Advantage
- Flex Advantage Rollover
- Flex Advantage Grace Period
- Limited Expenses
- Medical Expenses
- Appeal Rights
- Flex/HRA Medical Information Release Authorization
- Mobile App Login Instructions
- Medical Mileage Rate Change
- Transportation Benefits Monthly Maximum
Información de la Cuenta de Reembolso
Claim Forms
- Health FSA Reimbursement Request Form
- Orthodontic Expense Form
- Dependent Care FSA Reimbursement Request Form
- Daycare Reimbursement Contract
- Limited Purpose Reimbursement Request Form
- Mass Transportation Reimbursement Request Form
- Parking Expense Reimbursement Request Form
- HRA Claim Form / Expenses
- HRA Claim Form / Deductible Expenses
Formulario de Reclamos
- Formulario de Solicitud para el Reembolso de la Cuenta de Salud FSA (Cuenta de Gastos Flexibles)
- Formulario para Gastos de Ortodoncia
- Formulario para Guardería
- Contracto para Guardería
- Formulario de Solicitud para el Reembolso de Propósito Limitado
- Formulario para Gastos de Transporte Masivo
- Formulario para Gastos de Parqueo
- Formulario para Gastos de Reembolso de Salud
- Formulario de Reclamo HRA (Cuenta de Reembolso de Salud) / Gastos Deducibles
Videos
Contact Us
Your Allegiance account profile will be updated to include this email address for communication purposes.
Please contact Customer Service if you do not wish your account to be updated.