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UFCW LOCAL 1776 and PARTICIPATING EMPLOYERS                                   HEALTH and WELFARE FUND

 

Reimbursement

Any credits that you direct to deposit into your account will be forfeited if you do not submit your claim for reimbursement by march 31 of the following year. To request reimbursement under the Medical Flexible Spending Account, you must submit a reimbursement request form provided by the Fund, along with documentation of the expenses, using instructions printed on the form. (“Documentation” includes such items as a copy of the bill for the expenses, or the insurance company’s or other third-party provider’s explanation of benefits (EOB) statement showing that the expense was medically necessary, but not covered in full.) You may submit reimbursement requests for any amount at any time during the calendar year up to the $500 maximum. PLEASE NOTE: Expenses must be incurred during the same calendar year for which you allocate Benefits Credits, although you may request reimbursement until the next March 31 after the end of that calendar year. Also, you are responsible for submitting only those expenses which the IRS considers eligible. If the IRS does not allow an expense as an eligible medical expense, you will not be reimbursed for that expense.