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Forms
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| Management Information Systems | |
| Standard File Layout (24 kb) | Describes the layout for accepting data from third parties. |
| TSA File Layout (24 kb) | Layout for accepting data for Maximum Allowable Deductions (MAD) calculation. |
| Tax Sheltered Accounts (TSA) | |
| Self Enrollment Kit | Self Enrollment packet for an employee. |
| Solicitor's Kits | Solicitor's kits from Employers. |
| Provider Reports | Provider / Solicitor Report for Employers. |
| Employer Plan Documents | Employer Plan Document, Adoption Agreement, and Authorized Providers |
| Cafeteria Department | |
| File Layout for Data (15 kb) | File layout for electronic data submission to NPA. |
| Medical Reimbursement Form (35 kb) | Medical Reimbursement Form for claim. |
| Child Care Reimbursement Form (32 kb) | Child Care Reimbursement Form for claim. |
| Direct Deposit Authorization Form (30 kb) | Direct Deposit Authorization Form for reimbursements. |
| Transportation Reimbursement Form (24 kb) | |
| Walmart Notice (24 kb) | |
| Debit Card Documentation Claim Form (24 kb) | |
| Change Form (Employer Only) (25 kb) | |
| COBRA | |
| COBRA Notification Form (24 kb) | Cobra Notification Form to NPA. |
| COBRA Change Form (24 kb) | Cobra Change Form to NPA. |
| HRA - Health reimbursement Arrangements | |
| HRA Debit Card Claim Documentation Form (43 kb) | |
| HRA Debit Card Claim Documentation Form Instructions (37 kb) | |
| HRA Reimbursement Request Form (non-Debit Card) (39 kb) | |
| HRA Reimbursement Request Form Instructions(non-Debit Card) (17 kb) | |
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© 1998-2002 National Plan Administrators
Last Updated on: 2 SEP 2005