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Making Plan Changes?

We make the process of updating your plans quick and easy! Select the benefit you wish to update below and complete our amendment form.

HRA Plan Change

If your company wishes to amend your HRA, please click the form button and complete our online form.

Click Here

FSA Plan Renewal

If your company wishes to amend your FSA, please click the form button and complete our online form.

Click Here

Update COBRA Rates

If your company needs to update the rates for any COBRA eligible benefit, pleas click here and remit back to OCA.

Click Here

ICHRA Plan Change

If your company wishes to amend your ICHRA, please click the form button and complete our online form.

Click Here

Access Open Enrollment Material

CDH & COBRA

Enrollment Forms and Templates

HRA Enrollment Census Template

ICHRA Enrollment Census Template

FSA Enrollment Census Template

Commuter Enrollment Census Template

HSA Enrollment Census Template

OCA COBRA New Hire/QLE Template

Master Pre-Tax Enrollment Template

For Members

Benefit Account Flyers/Guides

Employee Guides and Flyers

For Members

Claim Forms

HRA Claim Form

FSA Claim Form

Dependent Care Claim Form

Commuter Claim Form

Employer/Account Holder

HSA Account Forms

HSA Employer Contribution Error Form

HSA Account Closure Form

HSA Name Change Request Form

HSA Account Holder Contribution Correction Form

HSA Withdrawal Form

HSA Transfer of Assets Form

HSA Distribution of Excess or Mistaken Contribution Form

HSA Contribution Form

HSA Beneficiary Form

For Employers

Non-Discrimination Questionnaire Forms

Premium Only Plan Non-Discrimination Questionnaire

Flexible Spending Account Non-Discrimination Questionnaire

HRA Non-Discrimination Questionnaire

 

For Employers

Banking/Invoicing

Client Banking/Invoicing Form (fillable PDF)

Client Banking/Invoicing Form (Online Submission Form)