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Health Care Reimbursement Account (HCRA)

This voluntary benefit plan offers eligible employees the ability to pay for eligible out-of-pocket health care expenses with pre-tax dollars:

Enrollment Information:

  • Eligible employees may enroll in the plan within 60 days of hire or during open enrollment.
  • To enroll, employees must complete the Benefits Worksheet and DCRA/HCRA Form. The DCRA/HCRA Form must be completed (initialed, signed, dated) and uploaded to the Benefits Worksheet.

To access the Benefits Worksheet, please follow the steps below:

  1. Log in to MyCoyote (for optimal viewing, please use Chrome or Firefox)
  2. Go to My Employment
  3. Go to Benefits Worksheet
  4. Click the "Create New Requests" button
  • For 2022, employees may contribute between $20 to $229.16 each month ($2,750 maximum per year) to their flexible spending account.
  • Beginning 2021, employees enrolled in this account will receive two (2) ASIFLex debit cards at no additional cost.  This card eliminates most out-of-pocket expenses and claims paperwork (exceptions apply). 
  • Contributions are deducted from the employee's pay before federal, state and Social Security (FICA) taxes are calculated.
  • Employees must re-enroll every year during open enrollment to continue participation for the following calendar year. To re-enroll, employees must complete a Benefits Worksheet and DCRA/HCRA Form.

Reimbursement Information:

  • Employees can file a claim for reimbursement online at with the ASI- assigned user ID and password, or by completing a HCRA/DCRA Claim Form and attaching an itemized bill for health care expenses.
    • Once you have filled out the form and attached all required documentation, you can fax it to (573) 874-0425 or mail it to:
      P.O. Box 6044
      Columbia, MO 65205-6044
  • In addition to the claims reimbursement processes outlined above, enrolled employees also have the option of requesting an FSA Debit Visa Card, also called the "ASIFlex​ Card." The Card eliminates most out-of-pocket expenses and claims paperwork (exceptions apply). 
  • Eligible expenses must be:
    • medically necessary,
    • incurred by an employee, employee's spouse, or eligible dependents (including domestic partner)
    • not covered by the employee's own or another insurance plan
  • Any money left in employee's account after expenses have been paid for the plan year may be forfeited.

    If an employee re-enrolls for the next plan year, there will be an extended grace period through March 15 of the following year.

    If an employee does not re-enroll for the next plan year, they must utilize all their funds by December 31st of their plan year.

  • Please refer to the Health Care Reimbursement Account Brochure for more detailed information.