Get Meijer Family Matters

Filling out the Meijer Family Matters form online can be a straightforward process. This guide will provide you with detailed steps to complete the form accurately and efficiently.

Follow the steps to complete your form successfully.

1. Press the 'Get Form' button to access the Meijer Family Matters form. This will allow you to open the document for editing.
2. Begin filling in the employee name field. Enter your full name as it appears in your official documents. Next, input your member number, which corresponds to your Meijer Employee ID Number.
3. In the employer name section, clearly indicate 'Employer: 116196 - Meijer Inc (Personal Health Bank)'. This ensures your claim is directed to the correct employer.
4. If you need to change your address, please reach out to your employer’s HR or Benefits department for assistance, as address changes cannot be processed directly.
5. For health care claims pertaining to you or your dependents, remember that dental and vision expenses are not eligible for reimbursement through your Personal Health Bank account. Review the coverage stipulations regarding insurance.
6. For expenses covered by insurance, submit your claim only after receiving an Explanation of Benefits Statement from your insurance company. Attach a copy of this statement along with your completed claim form.
7. For expenses not covered by insurance, provide an itemized statement from the provider. This should include the provider's name/address, patient name, service date, description, and the total amount charged.
8. When submitting prescription drug claims, ensure you include the drug name and provide either a pharmacy receipt or a printout of prescriptions from your pharmacy.
9. Document expenses for insurance premiums by providing acceptable documentation such as a bank statement, payment receipt, or insurance company statement that clearly identifies the premium paid.
10. Complete the section for 'Date of Service', 'Type of Service', and 'Amount Requested'. Total your claimed amount and document it in the designated field.
11. Finally, certify the information by signing the form in the employee signature section and adding the date of signing. Keep a copy for your records, as submitted documents will not be returned. If faxing the claim, retain the original.

Start completing your documents online today.