ABS Claims and Admin Forms

Medical Expenes Reimbursement Form
FSA Election Form
FSA Worksheet
2020 Updated FSA OTC List
ER Automated Clearing House (ACH) Form
Dependent Care Claim Form
Automated Clearing House (ACH) Authorization Form
213d Expenses Form

Mailing Address

Post Office Box 1635
Irmo, SC 29063

Phone / Fax Numbers:

803-407-0133
866-826-6554 (toll-free)
803-407-1649(fax)

Staff Extensions

Mark Riley - x2121
Myra Brown - x2115
Tracy Boatwright - x2131