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Formula Corporation Medical Reimbursement Plan 2919 Eagandale Blvd. Suite 120 Eagan MN 55121-4203 Fax 651-686-0513 If you receive reimbursement for these services they are not eligible for reimbursement from your HSA. MEDICAL/PHARMACY DEDUCTIBLE Submitting a copy of the Explanation of Benefits EOB form received from your health insurance will satisfy the above requirements. For any questions call 651-686-0108 ext. 106 or toll free 1-888-686-0412 ext. 106 Person Receiving Service Type of...
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