Forms
FSA Nutrition Card Now Accepted at Walmart
FSA TPA is pleased to welcome Walmart as its latest merchant to its expansive Nationwide EBT network of retailers. The FSA Nutrition card is a valuable tool for Tribal Nations looking to provide Nutrition benefits to their Tribal citizens in a secure and convenient manner. Click the PDF download to read the Press Release and learn more about the FSA Nutrition Card.
FSA TPA Claim Reimbursement Form
Form for reimbursable expenses under the Tribal Member Benefits Program.
FSA TPA Direct Deposit Authorization Form
Authorize your claim reimbursement by direct deposit into a checking or savings account.