- The employer maintains thing a Plan in Document; this document if Pl any conflicts Document, with then ontrols.
- I understand that any expenses paid under this Plan must be eligible expenses as governed by IRS regulations, must be for services provided for me or a qualifying individual and must not be reimbursed from any other source.
- I understand that Federal law requires financial institutions to obtain, verify and record information that identifies each person with an account.
- Furthermore, I understand that if my Beniversal Card is used for expenses other than eligible medical expenses or if I violate the terms of the Agreeme, I may ntlose Beniversal Card privileges and will rei...
Benefit Resource Health Reimbursement Account (HSA... 
