Coverage Programs banner

 

My FSA button


Forms and Resources

(PDF documents)

FSA Reimbursement Form

Dependent Care Reimbursement Account Brochure

Dependent Care Reimbursement Account Worksheet

Flexible Spending Account Direct Deposit Authorization Form

Healthcare FSA Brochure

Healthcare FSA List of
Eligible/Ineligible Expenses

Healthcare FSA Worksheet

Over-the-Counter Drugs and Medicines

 

Flexible Spending Accounts for Enrollees

At the LGC, we provide Flexible Spending Account (FSA) plans that can offer valuable tax savings for you. Click on the links below to access details about our FSA offerings:

If you already have an FSA plan through your employer, visit My FSA Account for accessing your password-protected FSA information. For more details about your FSA account, please contact your employer directly. You can also call LGC at 800.527.5001 or email our FSA Department.

If you are a member benefits administrator, please visit our Flexible Spending Account Administration web section.