Service Forms

Other

Letter of Medical Necessity for Security Flex 125 Program®

Download: By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax

816.701.7626

Download

For questions or assistance, please call 800.747.3942

Other

Medical/Dependent Care Reimbursement Program Claim for Security Flex 125 Program®

Download: Use this form to request medical expense or dependent care reimbursement.

By Mail

Security Flex 125
P.O. Box 75066
Topeka, KS 66675
United States

Overnight Delivery

Security Benefit
Mail Zone 600
One Security Benefit Place
Topeka, KS 66636
United States

By Fax

866.477.6526

Download

You may also email your form to [email protected]

Other

Reimbursable Over-the-Counter Medications & Program Updates for Security Flex 125 Program®

Download: By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax

816.701.7626

Download

For questions or assistance, please call 800.747.3942