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Discontinue my HCSA participation while on unpaid LOA. I understand I cannot request reimbursement from HCSA or use my Health Care FSA debit card for expenses incurred while on LOA. Continue my DCAP contributions while I am on my LOA. I understand I cannot request reimbursement from my DCAP account for expenses incurred while on LOA. -- PRE-PAY to cover / through / /201 incurred while on LOA. I m ending a LOA on / / 201 and wish to Reinstate my HCSA with the same annual amount. I understand...
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