Get Sbsadmin

Filling out the Sbsadmin Health Reimbursement Arrangement Claim Form online can streamline the reimbursement process and help you manage your health expenses efficiently. This guide provides clear instructions on how to accurately complete each section of the form, ensuring a smooth experience.

Follow the steps to complete your Health Reimbursement Arrangement Claim Form online.

1. Click ‘Get Form’ button to obtain the Health Reimbursement Arrangement Claim Form and open it in your designated editor.
2. In Section 1 (Employee Information), please print your name, social security number, address, day phone number, and city, state, and zip code. Ensure that you identify your employer and provide your email address, which may be used for any follow-up regarding your claim.
3. In Section 2 (Health Reimbursement Arrangement), attach an Explanation of Benefits (EOB) for the expenses being claimed. It is crucial that the EOB includes the date of service and the amounts eligible for your deductible. Complete the details for each expense incurred: state the date of service, name of the provider, description of the service, and the amount for each line item.
4. Sum the total of all unreimbursed deductible expenses in Section 2 and clearly indicate this total.
5. In Section 3 (Employee Certification), read the certification statement carefully. By signing, you confirm that all claimed expenses comply with your employer’s plan and that they have not been reimbursed through any other program. Provide your signature and date to validate your submission.
6. Once all sections have been completed, save your changes. You may have options to download, print, or share the completed form for submission as needed.

Take the next step in managing your health expenses by completing your Sbsadmin form online today.