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Get Hcfsa Claim Form 2022

The Health Care Flexible Spending Account Program is a division of the Office of Labor Relations Tax-Favored Benefits Program HEALTH CARE FLEXIBLE SPENDING ACCOUNT HCFSA PROGRAM Claims Form 40 Rector Street 3rd Floor New York NY 10006 Tel 212 306-7760 TTY 212 306-7629 nyc.gov/olr 1 Important Instructions and Information A Plan Year is the calendar year January 1-December 31 or for a newly eligible employee any remaining portion thereof. A Grace P.

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