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Flexible Spending Accounts
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Reimbursement Process |
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Reimbursement for dependent day care expenses
Here’s how to get reimbursed for eligible Dependent Day Care FSA expenses:
| 1. |
Pay your dependent care provider as usual. |
| 2. |
Submit an itemized receipt, along with a completed ADP Submitting Your FSA Dependent
Day Care Claim Form to the Flexible Spending Accounts Administrator. Your receipt must include the
following information:
| A. |
The caregiver’s name, address, taxpayer identification number (or
Social Security number) |
| B. |
The dates of service |
| C. |
The caregiver’s signature if your caregiver is an individual |
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| 3. |
Receive reimbursement as follows:
| A. |
You’re reimbursed up to the current balance in your account. |
| B. |
You’ll get a check for the amount that is currently funded if
there’s not enough money in your account to cover your entire claim. |
| C. |
You’ll be reimbursed for the balance of your claim as you
contribute to your account through payroll deductions. |
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Dependent Day Care FSA claims are processed daily. Claims must be for at least $5,
except for year-end claims. If you have questions about flexible reimbursements
or outstanding claims, you may contact the Flexible Spending Accounts
Administrator.
Reimbursement for health care expenses
Here’s how to get reimbursed for eligible Health Care FSA expenses:
| 1. |
Pay your health care bills as usual. |
| 2. |
If an expense is covered by the Advocate medical plan or dental
plan:
| A. |
Submit a claim to the appropriate plan.
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| B. |
When you receive your explanation of benefits (EOB), submit that
form along with a completed ADP Submitting Your FSA Health Care Claim Form to the Flexible Spending Accounts Administrator. |
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| 3. |
If an expense isn't covered by the Advocate medical plan or dental
plan or if you're in the HMO, submit the completed claim form
with your itemized bill or itemized receipt from your health care provider to
the Flexible Spending Accounts Administrator. Cancelled checks and credit card
receipts aren't acceptable documentation. |
| 4. |
You're reimbursed for the full amount of your claim, up to the annual amount
you decided to deposit into your Health Care FSA. |
Health Care FSA claims are processed daily. Claims must be for at least $5,
except for year-end claims. If you have questions about flexible spending
account reimbursements or outstanding claims, you may contact the Flexible Spending Accounts Administrator, ADP — by phone at 1-800-654-6695 (7 a.m. to 7 p.m., Monday-Friday), or
online at www.flexdirect.adp.com. See the Benefits Directory
for an address and fax number for written correspondence.
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