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235 per mile Amount of Charge MD RX DN VS OTCS OTCD NOTE EVERY OTC DRUG CLAIM REQUIRES A COPY OF THE PRESCRIPTION TO BE ATTACHED. Please itemize the expenses on your claim form. You can contact BeneFLEX HR Resources Inc. by e-mail at info beneflexhr. Available on iTunes or Google Play or Send your claim form along with all supporting documentation directly to BeneFLEX via email info beneflexhr. Check Your Account Balance Visit us online at www. beneflexhr. com click on Employee and then...
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An FSA plan reimbursement claim is a request to be reimbursed for eligible expenses paid out of a Flexible Spending Account (FSA).
Any employee enrolled in a company's FSA plan may be required to file a reimbursement claim in order to receive funds for eligible expenses.
To fill out an FSA plan reimbursement claim, one typically needs to provide information about the expense, the amount spent, and supporting documentation such as receipts.
The purpose of an FSA plan reimbursement claim is to request reimbursement for eligible out-of-pocket expenses paid with pre-tax dollars from an FSA.
The information reported on an FSA plan reimbursement claim usually includes details of the expense, amount spent, date of purchase, and any supporting documentation.
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