EMPOWER
Participant Resources for ICHRA
Advanced Flex Plan Administration with the Human Touch
Participant Resources for ICHRA
This page provides you with all forms and instructional guides for your EMPOWER ICHRA Plan.
Table of Contents
Forms
EMPOWER encourages you to use the Online Portal to ensure the fastest service (see the Instructional Guides and Tutorials section below for more information). However, forms are provided below for you to fill out and return to EMPOWER as an alternate way to use your benefits.
Direct Deposit Authorization Form
Add or change an existing bank account to receive reimbursements right to your bank account
Additional Resources
ICHRA Notice
the ICHRA Notice contains information for your specific plan. contact your Employer if you have not been provided with this Notice.
