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Get the free HCSA Claim Form - Western University - uwo

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As an employer in Ontario, Western University and its employees are obligated to contribute to certain programs which are set out by federal or provincial statute. They include the Canada Pension
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The HCSA claim form is a form used to request reimbursement for eligible healthcare expenses from a Health Care Spending Account (HCSA).
An individual who has incurred eligible healthcare expenses and wishes to be reimbursed from their HCSA account is required to file the HCSA claim form.
To fill out the HCSA claim form, you will need to provide information about the healthcare expenses incurred, including the date of service, type of service, provider information, and the amount paid.
The purpose of the HCSA claim form is to request reimbursement for eligible healthcare expenses that have been paid out of pocket.
The HCSA claim form must include details such as the date of service, type of service, provider information, and the amount paid for the healthcare expenses.
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