Get Opers Recurring Premium Reimbursement Form - Opers

This guide provides clear and comprehensive instructions on completing the OPERS Recurring Premium Reimbursement Form online. Designed to assist users with various levels of experience, this resource ensures that all necessary information is accurately submitted to facilitate the reimbursement process.

Follow the steps to successfully complete the OPERS recurring premium reimbursement form.

1. Press the ‘Get Form’ button to access the OPERS Recurring Premium Reimbursement Form online and open it in your editor.
2. In the first section, provide the account holder's name including last, first, and middle names, along with their Social Security number and zip code.
3. Indicate the relationship to the covered participant (e.g., self, spouse) and select the premium type (e.g., medical).
4. Enter the start and end dates of coverage in the MM/DD/YYYY format. Ensure the end date reflects the correct termination of coverage if applicable.
5. Fill in the amount requested for reimbursement, ensuring it is accurate based on supporting documentation.
6. Read the certification statement carefully before signing to confirm the accuracy of the information provided. Sign and date the form.
7. Compile and attach the required third-party documentation to verify your premium reimbursement request, ensuring it includes all necessary details such as the covered participant’s name and proof of premium.
8. Once all sections are complete, save your changes, and proceed to download, print, or share the form as needed.

Complete your OPERS Recurring Premium Reimbursement Form online today for a seamless reimbursement experience.