The Deadline for Submitting Eligible Expenses to Your FSA for Plan Year 2018 is March 31, 2019!
To avoid FSA forfeiture, you must have your final Plan Year 2018 claim form postmarked (by U.S. Mail, FedEx, UPS or other paid carrier) on or before March 31, 2019. Do not use interagency mail for this filing. All items received by interagency mail on or after April 1, 2019, will be deemed as not timely filed.
If you have Adobe Professional you can fill out the form and
save it as a different file for your records.
Mail the form and receipts to the address on the form or drop them off at the Employees Benefits FSA Department Offices at:
Address: 2401 N. Lincoln Blvd, RM 112, Oklahoma City, OK 73105
Main Phone: (405) 522-1190
Fax: (405) 522-1175
Autocalculating Flexible Spending Claim Form.
The fields will automatically calculate when values are entered in selected fields. This form meets Oklahoma 508 Accessibility Standards and is using the Employees Benefits Council Department Bar Code System for documents. This PDF revision requires Adobe Reader 8.0 to use the enhanced features correctly.
To generate a prefilled voucher, log in to the BAS site and choose Flexible Spending / File a Claim from the menu.
If you do not receive services prior to March 15 and submit the claim prior to March 31st, money left in the plan will be forfeited.
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