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Reimbursement Account Claim Format or Email completed form and documentation to: Fax: 18443068146 Email: PayFlex_Receipts@alegeus.comTo avoid claim processing delays, you must sign, date and complete
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How to fill out flexible spending health care

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How to fill out flexible spending health care

01
Gather all medical bills and receipts for the year.
02
Estimate how much you will spend on eligible medical expenses for the upcoming year.
03
Enroll in a flexible spending account (FSA) through your employer during open enrollment.
04
Decide how much money you want to contribute to your FSA for the year, keeping in mind the IRS limit.
05
Use your FSA debit card or submit reimbursement claims for eligible expenses throughout the year.
06
Keep track of your FSA balance and spending to ensure you do not exceed the annual contribution limit.

Who needs flexible spending health care?

01
Individuals who anticipate regular out-of-pocket medical expenses throughout the year.
02
Those who want to save money on eligible medical expenses by using pre-tax dollars.
03
People who want to budget for medical costs and have a dedicated account for health care expenses.
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Flexible Spending Health Care is an employee benefit that allows individuals to set aside a portion of their pre-tax earnings to pay for eligible medical expenses.
Employees who have enrolled in a flexible spending health care plan through their employer are required to file claims for reimbursement of eligible medical expenses.
To fill out flexible spending health care, individuals need to keep receipts of eligible medical expenses, complete a claim form provided by their employer, and submit the form along with receipts for reimbursement.
The purpose of flexible spending health care is to help individuals save money on out-of-pocket medical expenses by using pre-tax dollars.
Employees must report eligible medical expenses, dates of service, provider information, and total amount being requested for reimbursement on flexible spending health care forms.
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