Get Higginbotham Dependent Care

Completing the Higginbotham Dependent Care form online is a straightforward process designed to help you efficiently request reimbursement for eligible dependent care expenses. This guide will walk you through each section of the form to ensure you provide all necessary information.

Follow the steps to effectively complete your dependent care reimbursement request.

1. Click ‘Get Form’ button to retrieve the Higginbotham Dependent Care form and access it in your document editor.
2. Fill in your employer name and Guardian Group policy number. This information verifies your account with the program.
3. Enter your personal details, including your full name, location, mailing address, email address, social security number, and daytime phone number. Accurate contact information is essential for processing.
4. List the reimbursement amounts you are requesting for both health care and dependent care reimbursements. Ensure you provide the correct amounts as specified in your submissions.
5. For each dependent care expense, record the date incurred, the name of the dependent, and their date of birth. Accurate dates help validate your claim.
6. Provide the period covered for the expenses, including the start and end dates. This information clarifies the time frame for which you are requesting reimbursement.
7. Include service provider details, such as their name, taxpayer ID number, and address. This is necessary for verifying services provided.
8. Attach any required documentation to support your request, including itemized receipts and proof of any previous insurance reimbursements, as required by federal law.
9. Review your entries for accuracy. Ensure you have certified that the information is correct by signing and dating the form.
10. Save any changes you've made to the form, then download, print, or share it as needed for submission.

Complete your dependent care reimbursement request online today to facilitate the processing of your claims.