Independent Health Flexible Spending Account (FSA) Enrollment for UB Foundation (UBF)

Enroll in Independent Health's Flexible Spending Account. This is for use with UBF.

Learn more about your FSA

Download the Form

Independent Health Flexible Spending Account (FSA) Enrollment form
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Completing the PDF Form

  1. Read through all pages of the document to find specific instructions
  2. Enter requested information into the form
  3. Print the form
  4. Get required signatures
  5. Scan a copy of the signed form for your records
  6. Send the original form to the appropriate address:

Campus Mail

UB Foundation Human Resources
103 Center for Tomorrow
North Campus

External Mail (USPS)

UB Foundation Human Resources
P.O. Box 900
Buffalo, NY 14226-0900

Need Help Completing the Form?

Joyce Weeman

Joyce Weeman

Benefits Specialist

UB Foundation

Phone: 716-645-8731

Email: joycewee@buffalo.edu

avatar of Lisa Adamshick

Lisa Adamshick

Benefits Manager

UB Foundation

Phone: 716-645-8733

Email: ladamshi@buffalo.edu

Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: June 7, 2011

Owner: UB Foundation