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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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What is filling out hfll forms?
Filling out hfll forms refers to completing and submitting forms related to the Healthcare Flexible Spending Account (HFLL).
Who is required to file filling out hfll forms?
Employees who have a Healthcare Flexible Spending Account (HFSA) are required to file filling out hfll forms.
How to fill out filling out hfll forms?
To fill out filling out hfll forms, employees need to provide information about eligible healthcare expenses incurred during the plan year.
What is the purpose of filling out hfll forms?
The purpose of filling out hfll forms is to request reimbursement for eligible healthcare expenses paid out-of-pocket by the employee.
What information must be reported on filling out hfll forms?
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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