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This form is used by employees to request a Qualified Reservist Distribution (QRD) from their Healthcare Flexible Spending Account (FSA) in accordance with the Heroes Earnings Assistance and Relief
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How to fill out Qualified Reservist FSA Distribution Form

01
Obtain the Qualified Reservist FSA Distribution Form from your employer or the benefits provider.
02
Fill out your personal information, including your name, address, and contact details.
03
Provide your employment information, including your employer's name and address.
04
Indicate the appropriate category for your Reserve status and provide supporting documentation if required.
05
Specify the amount you wish to withdraw from your Flexible Spending Account (FSA).
06
Sign and date the form to certify that the information provided is accurate.
07
Submit the completed form to the designated benefits administrator or HR department.

Who needs Qualified Reservist FSA Distribution Form?

01
Reservists who have been called to active duty and need to access funds from their Flexible Spending Accounts.
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People Also Ask about

Certain rules allow reservists to repay retirement account distributions during the two-year period when active duty ends, even if the repayment contributions exceed annual contribution limits.
A qualified reservist distribution is: One made to a reservist called to active duty for a period of at least 180 days or for an indefinite period. Made beginning on the date of the order calling to active duty and ending on the close of the active duty period.
A qualified reservist distribution is: One made to a reservist called to active duty for a period of at least 180 days or for an indefinite period. Made beginning on the date of the order calling to active duty and ending on the close of the active duty period.
Qualified Reservist Distributions from Retirement Plans These provisions permit service members called to active duty for periods of 180 days or more to take withdrawals from qualified retirement plans and Health Flexible Spending Accounts as if they had terminated employment.
A qualifying distribution is: Any amount (including program-related investments) paid to accomplish religious, charitable, scientific, literary, or other public purposes.

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The Qualified Reservist FSA Distribution Form is a document that allows reservists called to active duty to withdraw funds from their Flexible Spending Accounts (FSAs) without incurring penalties, enabling them to access their pre-tax contributions while serving.
Reservists who have been activated for active duty for more than 179 days are required to file the Qualified Reservist FSA Distribution Form to access their FSA funds.
To fill out the Qualified Reservist FSA Distribution Form, individuals must provide their personal information, specify the amount requested, and include documentation of their activation orders as proof of eligibility.
The purpose of the Qualified Reservist FSA Distribution Form is to facilitate the tax-free withdrawal of funds from an FSA for reservists who are called to active duty, ensuring they can access funds for qualified expenses without penalties.
The information that must be reported on the Qualified Reservist FSA Distribution Form includes the reservist's name, contact information, FSA account number, amount to be withdrawn, and copies of active duty orders or other supporting documentation.
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Related Links

Qualified Reservist Distribution Health Care Flexible ...
Mar 4, 2020 — A reservist must request a distribution after the order or call to active duty, but before the last day of the plan year including the grace ...
HEART Reimbursement Act Form - MSU Human Resources
A Qualified Reservist Distribution (QRD) payment can be requested. Name: Address: Is this a new address? Yes. No. Employer: Michigan State University.
Flexible Spending Account Guide
... request a qualified reservist distribution on or after the date of the order or call to active duty, and before the last day of the plan year (or grace ...

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Relevant keywords

HCA Flexible Spending Account H.E.A.R.T. Act Qualified Reservist Distribution employee benefits Reservist Call to Duty healthcare benefits FSA deactivation tax implications Planned Benefit Systems

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