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1515 Saint Joseph Avenue P.O. Box 8000 Marsh field, WI 54449-8000 1-800-472-2363 or 715-221-9555 TTY 1-877-727-2232 or 715-221-9898 Wellness Benefit Reimbursement Request STEP 1: Participating member

How to fill out wellness benefit reimbursement request

How to fill out wellness benefit reimbursement request:

1. Obtain the wellness benefit reimbursement request form from your employer or insurance provider. This form may be available online or in a physical copy.
2. Begin by providing your personal information, such as your name, contact information, and employee or policy number. Ensure that all information is accurate and up-to-date.
3. Fill in the details of the wellness benefit you received. Include the date, type of wellness benefit (such as gym membership, nutrition counseling, or fitness classes), and the cost incurred.
4. Attach any supporting documentation that may be required. This may include receipts, invoices, or statements that prove the cost and nature of the wellness benefit.
5. Review the form thoroughly to ensure all information is complete and correct. Incorrect or missing information may delay the reimbursement process.
6. Sign and date the form to certify its accuracy.
7. Submit the filled-out wellness benefit reimbursement request form to your employer or insurance provider as instructed. This may involve mailing the form, submitting it online via a portal, or hand-delivering it to the appropriate department.

Who needs wellness benefit reimbursement request:

1. Employees who have incurred eligible wellness expenses and are eligible for reimbursement based on their employee benefits package or insurance policy.
2. Individuals covered under a health insurance plan that includes wellness benefit options.
3. Those who have participated in wellness programs or utilized wellness services and want to be reimbursed for eligible expenses.
4. People who want to take advantage of their employer's wellness benefits or insurance policy's coverage for wellness expenses and wish to submit a reimbursement request.

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What is wellness benefit reimbursement request?

A wellness benefit reimbursement request is a form used to request reimbursement for expenses related to wellness activities or programs that promote employee well-being.

Who is required to file wellness benefit reimbursement request?

Employees who have participated in wellness activities or programs that are eligible for reimbursement are required to file a wellness benefit reimbursement request.

How to fill out wellness benefit reimbursement request?

To fill out a wellness benefit reimbursement request, employees must provide information about the wellness activity or program, the date and cost of the expense, and any supporting documentation.

What is the purpose of wellness benefit reimbursement request?

The purpose of a wellness benefit reimbursement request is to encourage employees to participate in wellness activities and programs by providing financial support for associated expenses.

What information must be reported on wellness benefit reimbursement request?

Information such as the name of the wellness activity or program, date of the expense, cost of the expense, and any supporting documentation must be reported on a wellness benefit reimbursement request.

When is the deadline to file wellness benefit reimbursement request in 2023?

The deadline to file a wellness benefit reimbursement request in 2023 is December 31st.

What is the penalty for the late filing of wellness benefit reimbursement request?

The penalty for late filing of a wellness benefit reimbursement request may result in the denial of reimbursement or a reduction in the reimbursement amount.

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