Set Up Forms :


1 a. FlexSave Trust Application Form - Self Employed / Unincorporated Applicants

1 b. FlexSave Trust Application Form - Corporate Applicants

1 c. Credit Card Payment Form(To accompany Trust Application if paying Set Up Fee by credit card)

2. Employee Enrollment Form
- each employee must complete which includes the business owner/sole proprietor

3. Stop-Loss/Travel Medical Form(requirement for unincorporated business)
- each applicable employee must complete along with business owner


4. Pre-authorized debit
- for companies that wish to pre-fund their FlexSave plan on a monthly basis

5. Pre-authorized debit for STOP/LOSS monthly premium
- for companies that wish to pay stop/loss insurance on a monthly basis

6. Request for Direct Deposit (EFT)

Administration Forms :

1. Employee Termination
- Complete this form to remove an employee from the FlexSave plan

2. Address Changes
- Complete this form to change the address for the company or an individual employee