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RESET FORMFLEXIBLE BENEFIT PLAN ENROLLMENT APPLICATION Voya Benefits Company, LLC A member of the Voya family of companies Health Account Solutions: PO Box 1168, Minneapolis, MN 55440 Phone: 8332324673;

How to fill out voya-flexible-spending-reimbursement-request-form - peabody k12

How to fill out voya-flexible-spending-reimbursement-request-form

1. Obtain the Voya flexible spending reimbursement request form from the Voya website or your employer's HR department.
2. Fill out your personal information at the top of the form, including your name, address, and employee ID.
3. Enter the dates of service for the expenses you are claiming.
4. List the expenses you are requesting reimbursement for, along with the corresponding amounts and descriptions.
5. Attach all necessary documentation, such as receipts or invoices, to support your request.
6. Sign and date the form to certify that the information provided is accurate and complete.
7. Submit the completed form and documentation to the designated Voya processing address or upload through the online portal, if available.

Who needs voya-flexible-spending-reimbursement-request-form?

1. Employees who have enrolled in a flexible spending account (FSA) and wish to claim reimbursements for eligible expenses.
2. Individuals responsible for managing out-of-pocket healthcare expenses and seeking to utilize their FSA benefits.

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What is voya-flexible-spending-reimbursement-request-form?

The Voya Flexible Spending Reimbursement Request Form is a document used by individuals to request reimbursement for eligible expenses incurred under a flexible spending account (FSA).

Who is required to file voya-flexible-spending-reimbursement-request-form?

Employees who have a flexible spending account and wish to be reimbursed for qualified medical, dental, or dependent care expenses are required to file the Voya Flexible Spending Reimbursement Request Form.

How to fill out voya-flexible-spending-reimbursement-request-form?

To fill out the form, gather necessary receipts and documentation, provide personal and account information, detail the eligible expenses, and submit the completed form along with the receipts to Voya for processing.

What is the purpose of voya-flexible-spending-reimbursement-request-form?

The purpose of the Voya Flexible Spending Reimbursement Request Form is to allow participants to claim reimbursement for eligible out-of-pocket expenses paid for medical, dental, or dependent care during the plan year.

What information must be reported on voya-flexible-spending-reimbursement-request-form?

The form must include the participant's name, contact information, account number, the type of expense, dates of service, amount being claimed, and documentation (receipts) verifying the expenses.