Claim Forms

Before you submit a claim, review the Claim Filing Requirements to insure you understand what is required so that you can be sure to get your money back fast. Remember you can submit a paperless FSA claim online by clicking Online Access/Account Detail above or via the ASIFlex Mobile App.

Please select one of the following claim forms:


About Us

ASIFlex is a Third Party Administrator of employee benefit programs, and has over 400 clients around the nation.

We are located in Columbia, Missouri.

Go Green

Click the Go Green link above to manage your account or Click Here to print the form, then mail or fax it in.

Contact ASIFlex

  • Phone: 1-800-659-3035
  • Email: [email protected] *For your security, please do not include any specific health information in an email.
  • Fax: 1-877-879-9038

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