Get the free NDPERS Wellness Program Voucher - UND University of North - und

PAPERS Wellness Program Voucher For programs starting July 1 Last Name: First Name: Birth Date: M D D C C Y Member ID Number: (found on Sanford Health Plan ID Card) Underwritten by: Dakota Plan Health

How to fill out ndpers wellness program voucher

How to fill out ndpers wellness program voucher:

1. Obtain the ndpers wellness program voucher form from the appropriate source, such as the official website or your employer.
2. Begin by providing your personal information, including your full name, employee or member ID, and contact details.
3. Fill in the date on which you are submitting the voucher.
4. Next, indicate the type of wellness activity or program you participated in by checking the corresponding box or writing it in.
5. Provide a brief description of the activity or program, including the name, location, and duration.
6. Specify the date(s) on which you participated in the activity or program.
7. If applicable, attach any supporting documents, such as registration confirmation or attendance certificates, to validate your participation.
8. Calculate and enter the total cost of the wellness activity or program. This may include registration fees, materials, or other relevant expenses.
9. Indicate whether the cost was fully covered by you or if it was partially reimbursed by another party, such as your insurance.
10. Finally, sign and date the form to certify that the information provided is accurate and complete.

Who needs ndpers wellness program voucher:

1. Employees or members who are eligible for the ndpers wellness program may need to obtain and fill out the voucher.
2. Participants who have engaged in wellness activities or programs that are eligible for reimbursement or incentives from ndpers should use the voucher.
3. Individuals who wish to track their wellness activities and receive benefits through the ndpers program may be required to submit the voucher as part of the process.

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What is ndpers wellness program voucher?

The ndpers wellness program voucher is a form used by North Dakota Public Employees Retirement System (NDPERS) members to claim reimbursements for approved wellness program expenses.

Who is required to file ndpers wellness program voucher?

NDPERS members who participate in the wellness program and wish to claim reimbursements for approved expenses are required to file the ndpers wellness program voucher.

How to fill out ndpers wellness program voucher?

To fill out the ndpers wellness program voucher, members need to provide details of the wellness program expenses they wish to claim reimbursement for and submit the form along with any necessary supporting documentation.

What is the purpose of ndpers wellness program voucher?

The purpose of the ndpers wellness program voucher is to provide NDPERS members with a way to claim reimbursements for approved wellness program expenses, encouraging them to lead healthier lifestyles.

What information must be reported on ndpers wellness program voucher?

Members must report details of the wellness program expenses they are claiming reimbursements for, including the date of service, type of service, and amount paid.

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