Get the free Healthy Living Reimbursement Request

1515 North Saint Joseph Avenue PO Box 8000 Marshfield, WI 544498000 1.800.472.2363 | 715.221.9555 TTY 7112023 Healthy Living Reimbursement Request Security Health Plan offers a healthy living benefit

How to fill out healthy living reimbursement request

How to fill out healthy living reimbursement request

1. To fill out a healthy living reimbursement request, follow these steps:
2. Obtain a copy of the reimbursement request form from your health insurance provider or download it from their website.
3. Fill in your personal information, such as your name, address, and contact details.
4. Provide your health insurance policy number and group number.
5. Specify the type of health expenses you are seeking reimbursement for, such as gym membership fees, fitness classes, or wellness programs.
6. Attach scanned copies or original receipts of the expenses you are claiming for reimbursement.
7. Fill out the amount you are requesting to be reimbursed for each expense item.
8. Review the completed form for accuracy and completeness.
9. Sign and date the reimbursement request form.
10. Submit the form along with all supporting documents to your health insurance provider either online, by mail, or in person.
11. Keep a copy of the filled-out form and receipts for your records.

Who needs healthy living reimbursement request?

1. Anyone who has a health insurance policy and has incurred eligible health-related expenses may need to fill out a healthy living reimbursement request.

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What is healthy living reimbursement request?

A healthy living reimbursement request is a formal application submitted by individuals to seek reimbursement for eligible health and wellness expenses incurred as part of a healthy living program.

Who is required to file healthy living reimbursement request?

Employees or members participating in a health and wellness program that offers reimbursement for qualifying expenses typically need to file this request.

How to fill out healthy living reimbursement request?

To fill out the healthy living reimbursement request, you should provide necessary personal information, itemize the eligible expenses, attach receipts, and sign the form before submitting it to the appropriate department.

What is the purpose of healthy living reimbursement request?

The purpose of the healthy living reimbursement request is to allow individuals to recover costs associated with health-promoting activities and services that are covered under employer-sponsored wellness programs.

What information must be reported on healthy living reimbursement request?

The request must include personal details (name, employee ID), a list of eligible expenses, dates of service, amounts for each expense, and any required documentation such as receipts.