Health & Welfare Forms
Health Reimbursement Arrangement (HRA)
Flexible Spending Account (FSA)
To access forms related to the plans below—including Distribution Forms and Beneficiary Designation Forms—you will be prompted to log into your MidAmerica online account. Once logged in, select Forms from the Forms & Reports dropdown in the top blue header.
Click your plan type below to login.
Why do I have to log in to access my plan forms?
These forms are only accessible through secure account access to help protect your account from fraudulent transaction requests. HRA and FSA forms are made publicly available because of the substantiating documentation that’s required with many of those form submissions.
CARES Act Self Certification Form