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Health Care FSA Claim
MAIL:
PO BOX 7500
CHAMPAIGN, IL
618267500FAX:
8777607076ONLINE:
www.mywealthcareonline.com/bpcincPHONE:
8772728880Employer:Day Time Phone Number:x x ISSN:Participant Name (please
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What is health care fsa claim?
A health care FSA claim is a request for reimbursement of eligible medical expenses paid out-of-pocket using funds from a Health Care Flexible Spending Account.
Who is required to file health care fsa claim?
Employees who have contributed to a Health Care Flexible Spending Account are required to file health care FSA claims for reimbursement of eligible medical expenses.
How to fill out health care fsa claim?
To fill out a health care FSA claim, employees must provide details of the medical expenses incurred, including the date of service, the amount paid, and proof of payment.
What is the purpose of health care fsa claim?
The purpose of a health care FSA claim is to request reimbursement for eligible medical expenses paid out-of-pocket using pre-tax dollars contributed to the FSA.
What information must be reported on health care fsa claim?
The information reported on a health care FSA claim must include details of the medical expenses incurred, such as the date of service, the provider’s name, the amount paid, and proof of payment.
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