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EXPENSE REIMBURSEMENT VOUCHER FOR HEALTH FLEXIBLE SPENDING ARRANGEMENT (HEALTH FSA) OR HEALTH REIMBURSEMENT ARRANGEMENT (HRA) Name of Employee (Last, First, MI) Social Security # Mailing Address E-mail
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What is health flexible spending arrangement?
A health flexible spending arrangement is a tax-advantaged account that allows employees to contribute a portion of their salary to pay for qualified medical expenses.
Who is required to file health flexible spending arrangement?
Employers offering health flexible spending arrangements are required to file.
How to fill out health flexible spending arrangement?
Employers must provide employees with the necessary paperwork to elect their contribution amount and submit it to the plan administrator.
What is the purpose of health flexible spending arrangement?
The purpose of a health flexible spending arrangement is to help employees save money on out-of-pocket medical expenses by using pre-tax dollars.
What information must be reported on health flexible spending arrangement?
The amount contributed by the employee, any reimbursements made, and a list of qualified medical expenses paid for with the account.
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