CGI Employee Benefits Group - A diversified full service employee benefits brokerage and consulting firm dedicated to providing the highest level of personalized service and objective advice with offices located in New Hampshire and Vermont.

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Our Services Cafeteria Plans (FSA/POP) Healthcare Reimbursement Arrangements (HRA) COBRA Forms and Documents Helpful Resources Contact Information

	Participant Forms and Documents
	Flex Claim Form
	HRA Claim Form
	mySourceCard Submittal of Receipts
	Direct Deposit Form
	Summary of Claims Submitted
	Planning Expense Worksheet
	Privacy Notice
	Change of Status Form
	Employer Forms and Documents
	Change of Status Form
	Termination Form

Corporate Headquarters:
    New Hampshire
    171 Londonderry Turnpike
    Hooksett, NH 03106
    603- 622-4600
    Toll Free: 1-866-841-4600
    Fax: 603-622-4618

Maine
    PO Box 573
    Bath, ME 04530
    207-389-1990
    Direct Fax: 207-389-1991

Vermont
    P.O. Box 6141
    Rutland, VT 05702
    802-775-2823
    Toll Free: 1-866-223-1140
    Direct Fax: 866-415-7807

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