Get the free Dependent Care Account Claim Form - Premera Blue Cross

How to Submit a Claim for Dependent Care Accounts We offer three easy ways for you to access your Dependent Care Account funds. For fastest results, we encourage you to submit your claim with the

How to fill out dependent care account claim

How to fill out dependent care account claim

1. To fill out a dependent care account claim form, follow these steps:
2. Obtain the dependent care account claim form from your employer or from the website of your account administrator.
3. Provide your personal information, such as your name, address, and contact details.
4. Enter the information of your dependent(s) for whom you are claiming expenses.
5. Specify the dates of service for which you are seeking reimbursement.
6. Itemize the eligible expenses you incurred for dependent care services, such as daycare or after-school programs.
7. Attach any necessary supporting documentation, such as receipts or invoices, to verify the expenses claimed.
8. Sign and date the form.
9. Submit the completed form and supporting documents to your account administrator by the specified deadline.
10. Keep a copy of the completed form and supporting documents for your records.

Who needs dependent care account claim?

1. Any individual who has a dependent and has contributed to a dependent care account can potentially make use of the dependent care account claim.
2. Dependent care accounts are typically offered by employers as part of a benefits package and are designed to help employees cover eligible dependent care expenses.
3. Parents or legal guardians who incur expenses for child care, daycare, nursery school, or after-school programs for their dependent children may need to file a dependent care account claim to seek reimbursement for these expenses.
4. It is important to note that eligibility and specific requirements may vary depending on the employer's plan and the rules set forth by the account administrator.

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What is dependent care account claim?

A dependent care account claim is a request for reimbursement for eligible dependent care expenses paid out of a dependent care account.

Who is required to file dependent care account claim?

The individual who has contributed to a dependent care account and incurred eligible dependent care expenses is required to file a dependent care account claim.

How to fill out dependent care account claim?

To fill out a dependent care account claim, one must gather documentation of eligible dependent care expenses, complete the claim form provided by the account administrator, and submit it along with the required documentation.

What is the purpose of dependent care account claim?

The purpose of a dependent care account claim is to request reimbursement for eligible dependent care expenses paid by the account holder.

What information must be reported on dependent care account claim?

Information such as the date of service, provider name, cost of service, and proof of payment must be reported on a dependent care account claim.