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Qualified Reservist Distribution (QRD) Request Form

Employees use this form to request a Qualified Reservist Distribution (QRD) from their health flexible spending account. Employees will need to complete the form, attach a copy of their orders or call to duty and submit the form to their employer for approval. Once approved, the request and documentation is faxed to Discovery at 866-451-3245 for processing. Please call Participant Services at 866-451-3399 if there are questions when completing the form. Also visit FAQs on our web site for more information about Qualified Reservist Distributions.

Form Type: Reimbursement and Substantiation
Categories: FSA

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