Get the free 2015-16 Wellness Reimbursement Form - stfrancisschools

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SCHOOL BOARD: St. Francis School District ROBERT G. BOKNEVITZ, President AMANDA J. BEARSKIN, Vice President RUSSELL J. ANSI, Treasurer CHRIS FINCH, Clerk SUSAN SAFER, Member 4225 South Lake Drive

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How to fill out 2015-16 wellness reimbursement form

How to fill out 2015-16 wellness reimbursement form:

01

Obtain the 2015-16 wellness reimbursement form from your employer or insurance provider. It may be available online or in a physical copy.

02

Begin by providing your personal information, such as your name, address, and contact details. Make sure to fill in all the required fields accurately.

03

Next, you may be asked to provide details about your insurance policy. This can include the policy number, group number, and the name of the insurance provider.

04

Proceed to the section where you need to describe the wellness expenses you are seeking reimbursement for. This may include costs related to gym memberships, health screenings, or wellness programs. Be sure to provide specific details about each expense, including the date, description, and amount.

05

If required, attach any supporting documents to substantiate your wellness expenses. This could include receipts, invoices, or other proof of payment. Make sure to keep copies for your records.

06

Before submitting the form, review all the information you have provided to ensure accuracy and completeness. Double-check the form for any missing fields or errors.

07

Finally, sign and date the form to certify that the information you provided is correct to the best of your knowledge. Submit the completed form to the designated individual or department as instructed by your employer or insurance provider.

Who needs 2015-16 wellness reimbursement form?

01

Employees who have eligible wellness expenses and are seeking reimbursement from their employer or insurance provider may need to fill out the 2015-16 wellness reimbursement form.

02

Individuals covered under an insurance policy that offers wellness reimbursement benefits may be required to complete this form in order to receive the reimbursement.

03

Employers or insurance providers may request employees or policyholders to fill out this form as part of their wellness program or benefits package to promote employee health and well-being.

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