Welcome to PIOPAC Fidelity Administrative Services!
Welcome Flexible Spending Account Participant,
Check your balance, file or substantiate a claim online.
(AFTER 5/1/2014 - https://piopacee.lh1ondemand.com).
Access individual forms below:
• Debit Card Benny Visa Application
• Direct Deposit Agreement
• Eligible & Ineligible Expenses
• FSA Handbook
• FSA/HRA Reimbursement Request Form
• Reimbursement Request - addendum
• No Receipt Retailers for your BENNY™ Debit Card
• Salary Redirection Agreement (SRA)
• Trans/Park Reimbursement Request Form
Submit claims using MOBILE App, or login into secured website and remit claims directly online and upload receipts.
Requests for reimbursement may be scanned and emailed to firstname.lastname@example.org,
faxed to (808) 536-0430, or mailed to 1132 Bishop Street, #2101, Hon., HI 96813.
We highly encourage Direct Deposit into your bank account as the most efficient method for you to receive your reimbursement. If you elect to receive a check and it is lost or not cashed within 60 days, there will be a $28.00 service fee to replace it.
A few reminders when filing your reimbursements:
To expedite the processing of your claim, please tape all receipts to a letter size sheet of paper - do not use staples. Please complete the claim form in its entirety, including your signature and date. Incomplete claims may delay processing of your reimbursement. Do not indicate "See Attached" in any field.
Reimbursement requests for less than $15.00 will be held until subsequent requests exceed the minimum check issue amount.
If you have any questions regarding your FSA claims processing, please email us at FSAclaims@piopac.com or call us at (808) 526-0097 ext. 226.