Follow the steps to successfully complete the Tabenflex form.

1. Click the ‘Get Form’ button to access the Tabenflex form and open it in the online editor.
2. Begin filling out the form by entering your last name, first name, and middle initial in the designated fields. Ensure that this information is clear and legible.
3. Provide your employer's name in the corresponding section, which helps in processing your claim accurately.
4. Enter your Social Security Number or Employee ID as appropriate in the next field to identify your claim.
5. If you have a new address, check the box labeled 'NEW ADDRESS,' then fill out your street address, city, state, and zip code.
6. Indicate the type of reimbursement you are requesting by selecting one of the options: Medical FSA, HRA, or Dependent Care FSA. Provide details for dependent care if applicable.
7. For dependent care claims, provide the name of the dependent, the dates care was provided, and their age during that period.
8. Fill out the name and address of the care provider, as well as the provider's ID or Social Security Number.
9. Input the amount requested for reimbursement in the appropriate section. Ensure this amount is correct and add it to the total.
10. For medical FSA or HRA claims, indicate the type of plan, the date medical care was provided, the merchant or provider name, and a description of the medical expense.
11. Enter the name of the person receiving the service or product, along with any medical mileage details if applicable.
12. Review the reimbursement guidelines and attach any necessary supporting documentation, such as Explanation of Benefits statements or receipts.
13. After completing all sections, double-check your entries for accuracy, and then select options to save changes, download, print, or share the completed form before final submission.

Complete your Tabenflex reimbursement requests online today for a hassle-free experience.