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Print Form STATE OF HAWAII DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS WAGE STANDARDS DIVISION Princess Keelikolani Building 830 Punchbowl Street Room 340 Honolulu Hawaii 96813 INSTRUCTION SHEET FOR HFLL-1 HAWAII FAMILY LEAVE CERTIFICATION OF SERIOUS HEALTH CONDITION Instructions Please completely fill out the HFLL-1 HAWAII FAMILY LEAVE CERTIFICATION OF SERIOUS HEALTH CONDITION. Please remember to sign and date the form before submitting it. Visit our Website at www. labor. hawaii. gov for...
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Filling out hfll forms refers to completing and submitting forms related to the Healthcare Flexible Spending Account (HFLL).
Employees who have a Healthcare Flexible Spending Account (HFSA) are required to file filling out hfll forms.
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The purpose of filling out hfll forms is to request reimbursement for eligible healthcare expenses paid out-of-pocket by the employee.
Employees must report the date of service, type of service, provider name, and amount paid for each eligible healthcare expense on filling out hfll forms.
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