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  • (cbp) Reimbursement Claim Form - Benefit Resource Home - Shu

Get (cbp) Reimbursement Claim Form - Benefit Resource Home - Shu

COMMUTER BENEFIT PLAN (CBP): REIMBURSEMENT CLAIM FORM (PLEASE PRINT CLEARLY) PART 1 Employee Name: Member ID: City, State, Zip: Employer: PART 3 Provider of Qualified Expense Month of Service Year.

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With just a swipe of the Beniversal Card at a qualified merchant, necessary funds for the transaction are deducted from the applicable account. No waiting for reimbursement. Enable your card for contactless payments through Google Pay®, Apple Pay®, and Samsung Pay® digital wallets.

Qualified merchants include medical providers such as: Chiropractors, Medical labs, Vision centers, Doctors, Medical supply stores, IIAS merchants, Dentists, Orthodontists, 90% merchants, Hospitals & Podiatrists. There is no cash or ATM access on the Beniversal Card.

Starting a Claim Now that you are logged into BRIWEB, you can submit a claim for any of the accounts that you are enrolled in by clicking “Submit Claims/Receipts” from the left-hand Navigation Menu.

With your Beniversal® Prepaid Mastercard® or eTRAC® Prepaid Mastercard handy, just call the Participant Services phone number at (800) 473-9595. Select the option from the prompt to hear your card balance and provide your card number and CVV. The automated system will then read you the balance in your account(s).

The Beniversal Card can be used directly at approved merchants providing mass transit and parking services. If a participant receives a bill or invoice for parking services and the approved provider accepts Debit Mastercard, the participant can provide the Beniversal Card number to initiate payment.

Within the MTA eTix app, configure your account to pull payment from your Beniversal Prepaid Mastercard / eTRAC Prepaid Mastercard. When you buy tickets, funds will be pulled from your card.

File your claim online via the employee portal (BRIWEB) or via the BRIMOBILE app. SUBMIT CLAIM BY MAIL OR FAX: MAILING ADDRESS: Benefit Resource, LLC | PO BOX 642 | Willow Grove, PA 19090 FAX NUMBER: (877) 918-3622 What are you requesting a reimbursement for? (One claim type per form.)

How do I use my Commuter Account? Set aside pre-tax dollars, up to the IRS limits, to pay for eligible mass transit and parking expenses. Change elections. Election changes are not limited by a plan year and can generally be updated monthly. ... Carry over unused funds. You carry over unused funds from month-to-month.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232