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How to fill out the Dakotacare Flex online
The Dakotacare Flex document is an essential tool for employees and participants in the Flexible Benefit Plan offered by the State of South Dakota. This guide provides clear, step-by-step instructions to assist users in completing the form accurately and efficiently.
Follow the steps to fill out the Dakotacare Flex form with ease.
- Click ‘Get Form’ button to obtain the Dakotacare Flex document and open it in your preferred editor.
- Locate the section for Employee Information. Here, you will need to fill in your Insurance ID, Employee/Participant Name, and Employee SSN accurately.
- In the Direct Deposit Authorization section, indicate whether you prefer to deposit funds into your Checking account or Savings account by checking the appropriate option.
- Enter your Account Number and the name of your Depository (Financial Institution). Ensure that the name matches the records your bank has on file.
- Provide the Branch, City, and State for your financial institution to ensure proper routing of funds.
- Fill in the Bank ACH Transit Routing Number, which can typically be found on the bank's website or by contacting them directly.
- Attach an actual voided check to the document in the designated area to verify your account details. Note that this form cannot be processed without a voided check.
- Review the authority statement regarding the continuation of this authorization and your responsibility with bank fees. This ensures you are fully informed of your obligations.
- Sign and date the form at the bottom to complete your authorization.
- Once you have filled out all the required sections, save your changes. You can then download, print, or share the completed Dakotacare Flex form as needed.
Complete your Dakotacare Flex form online today to streamline your reimbursement process.
Eligibility for Dakotacare Flex generally includes individuals who are enrolled in specific health plans offered by Dakotacare. This may include employees of participating employers, their spouses, and dependents. It's important to review your specific plan details to understand the coverage options. If you have further questions, uslegalforms provides resources to help clarify eligibility requirements.
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