Get Manley Forms

Filling out the Manley Forms online is an important step in managing your reimbursement requests efficiently. This guide will walk you through the process step-by-step, ensuring that you have all the necessary information at your fingertips.

Follow the steps to complete your Manley Forms online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your employee information. Fill in your employer's name, your 11-digit Manley ID number, and your last name, first name, and middle initial. Ensure that the mailing address, including street, apartment number (if applicable), city, state, and ZIP code, is complete. Additionally, provide your home and work phone numbers.
3. Indicate whether your address is new by checking the provided box if applicable. Review options about the grace period for eligible expenses and select your desired processing year for reimbursement.
4. Move on to the reimbursement request section. Choose the type of expense by checking the appropriate box: Unreimbursed Health-Related Expense (HRE) or Other Health-Related Premium (OHP). Fill in the amount, service date, and a brief description for each expense listed.
5. For dependent care expenses, fill in the total amount for childcare or adult daycare expenses. Make sure this section reflects any applicable expenses securely.
6. Calculate the total reimbursement requested and enter this amount in the designated field.
7. If required, ensure you have the signature of the provider where indicated. This is necessary only if sufficient documentation is not available.
8. In the authorization section, confirm that your statements are complete and true. Ensure you understand the guidelines and that your submitted expenses meet eligibility criteria. Provide your signature and date in the designated fields.
9. Finally, review the entire form for accuracy. Save any changes you made, and then download or print the form as needed. Ensure you retain copies of all documentation before submitting it.

Start completing your Manley Forms online today for a seamless reimbursement process.