Reimbursement

Reimbursement

Once you have money in your Spending Accounts, you can withdraw an amount from each account to pay yourself back for incurred expenses that are eligible for reimbursement from that account. Healthcare expenses cannot be reimbursed from the Dependent Care Account and dependent care expenses cannot be reimbursed from the Medical Care Account.

Claims must be incurred during the plan year in order to be reimbursed.

Required Documentation

To be reimbursed - or paid back - with tax-free dollars, you must submit the following items:

· A completed reimbursement form

· Your receipts for expenses. Receipts for healthcare expenses must include: date of service, name of patient, name of doctor or provider of service, type of service performed and amount owed by you. Receipts for dependent care expenses must show: period covered, name and age of dependent, name of provider, federal tax I.D. or Social Security number of provider, and amount paid.

Cancelled checks and credit card receipts are not acceptable receipts.

In order to avoid conflicts between the different brands and versions of word processors, our application file is in Adobe Acrobat v4.0 format. You will need Adobe Acrobat to read this file, download it for free by clicking the "Get Adobe Reader" button. For technical support for this program, contact Adobe.

For information or personal assistance, please contact our Benefits Department by clicking HERE.

| Home |

| Links | Privacy & Legal Statement | Site Index |