Other Benefit Forms

Forms Description Access Information
  • Health Care Flexible Spending Account (HFSA) Claim Forms
  • Dependent Care Flexible Spending Account (DFSA) Claim Forms
  • If you are enrolled in an HFSA: Use Your Spending Account™ (YSA) to be reimbursed for eligible healthcare expenses. You can use your YSA HFSA debit card or submit claims to YSA.
  • If you are enrolled in a DFSA: Use YSA to be reimbursed for eligible dependent care expenses
  • Submit claims (and attach necessary documentation) for reimbursement of eligible expenses

Your Benefits Resources (YBR) website:
http://resources.hewitt.com/nokia
1-888-232-4111

Long-Term Care Insurance Plan Forms

Note: Plan closed to new entrants

Complete a form when filing a claim or to grant MetLife access to your medical records from your physician

MetLife:
1-800-984-8651

Savings Plan Forms

  • Request a Rollover Contribution Form
  • Get other required forms (if any)

YBR website:
http://resources.hewitt.com/nokia
1-888-232-4111

Nokia Declaration of Domestic Partnership Form

Complete and submit the form when Nokia requests confirmation of your relationship with your domestic partner

Declaration of Domestic Partnership

Questions? Call 1-888-232-4111