Provess - Flexible Benefits

Flexible Benefits

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	Contact Information Provess Flexible Benefits 4050 Katella Avenue, Suite 213 Los Alamitos, CA 90720 Phone: (866) 639-5289 E-Fax: (866) 264-4093 E-mail: admin@provess.com Palm Springs and Midwest Locations...

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September 2009

New Provess Website...

August 2009

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Download Forms

If you are a client that has specific forms, please refer to your Client and Employee Portal.

Flexible Spending Account Download Forms
	•Election to Participate Form	•Benefit Election Change Request
	•Election Form (Hawaii)	•Provess Company Profile Brochure
	•Change Form	•Provess Cafeteria Plan Brochure
	•Dependent Care Verification Form
	•Benefit Reimbursement Voucher

Life and Health Download - Allstate Forms
	•Group Cancer Insurance Brochure	•Application for Life and Health Insurance
	•Group Accident Insurance Brochure	•Accident Claim Form
	•Critical Illness Brochure	•Certification That Illustration Was Not Used
		•Critical Illness Claim Form
		•Required Disclosure Statement for Accelerated Benefits Rider
		•Cancer Heart Stroke Specified Disease Claim Form
		•Policy Holder's Change Request
		•Wellness Claim Form
		•Change of Beneficiary
New Hire Kit
	•Download

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