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FORMS

HRA Reimbursement Receipt Validation Process

 

Step one: Click below to begin your reimbursement request

Step two: Complete the form, attach valid receipts of your qualified expenses or copies of your premium payments for the month you are requesting reimbursement. Please submit the form for processing*

Step Three: Once your request is received, Smart Choices Health will validate it per the IRS requirements. A validation email will be sent to your employer on a monthly basis to initiate payment.

Note: Only one month per reimbursement request is allowed however you can submit multiple requests.

*If this is your first reimbursement of the plan year please complete the Initial MEC Attestation Form

Initial MEC Attestation Form

Here are the 5 tips for reimbursement success 
  1. Submit legible receipts that include dates of service or payment
  2. Include the amount requested to avoid processing delays
  3. Remember to only submit one month at a time per submission
  4. Make sure the name of the employee is on the submission
  5. Be sure to upload documents correctly so they are easy to read
Reimbursement Form

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