Get Kaiser Aluminum Salaried Retirees Veba Plan 2013 Qualified Benefit Reimbursement Request Form

This guide provides clear, step-by-step instructions for filling out the Kaiser Aluminum Salaried Retirees Veba Plan 2013 Qualified Benefit Reimbursement Request Form online. Ensuring accuracy and completeness is important for a successful submission of your reimbursement request.

Follow the steps to complete your reimbursement request form online:

1. Click ‘Get Form’ button to obtain the Kaiser Aluminum Salaried Retirees Veba Plan 2013 Qualified Benefit Reimbursement Request Form and open it in your preferred editing tool.
2. In the first section, fill out your personal information, including the name of the retiree or surviving spouse, their Social Security number, and the name of the designated family unit representative.
3. Provide your mailing address, including street or P.O. Box, city, state, zip code, and a contact telephone number. If available, include your email address.
4. In the subsequent sections, specify the amounts you are claiming for Medicare Part B Premiums, Medicare Part D Premiums, and Other Health Care Premiums, ensuring that the total amount claimed is correctly calculated.
5. Attach all required proofs of coverage and payment to the form, including any documentation specified for Medicare premiums.
6. Complete the certification section by signing and dating the form, confirming that the information provided is complete and accurate.
7. Once all fields are filled out and documents attached, save the form and submit it according to the guidelines provided for reimbursement.

Begin your reimbursement request by completing the form online today.