On the Dashboard, select your name and then select Banking Information. 2023 airSlate Inc. All rights reserved. We are currently building a new site with accessibility in mind. The signNow extension provides you with a variety of features (merging PDFs, adding several signers, and so on) for a much better signing experience. Note: For help locating your banking information, select the?next toAccount Number. Your Reimbursement Guide provides more details on reimbursable expenses. This article applies to you if you have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement).*. 2. Original Medicare, Parts A and B, pays for most of your health care expenses, but it doesn't pay for everything. Select our signature solution and leave behind the old days with affordability, efficiency and security. Your reimbursement request must be submitted with third-party documents that include: Payments by check are held until the amount is greater than $25; however, if you establish direct deposit, the minimum payment is $1. Provide the required information on the Add Bank Account page.7. The form is available by calling us and using our automated voice system or by speaking with a Via Benefits representative. These alerts don't prevent you from using your account. If so, you dont need to submit documentation, and you automatically receive your monthly reimbursement payments. Create an account using your email or sign in via Google or Facebook. You can be reimbursed for an out-of-pocket medical expense as long as it's an eligible expense (such as an office visit or prescription copay, dental treatment, hearing aids, etc.) and signature of the Dependant Care Provider. *Via Benefits reimbursement accounts are administered by Extend Health, LLC. After its signed its up to you on how to export your my via benefits funds forms: download it to your mobile device, upload it to the cloud or send it to another party via email. If not, lets us know and we will get it added. A reimbursement account is set up by your former employer or benefits provider with a specific contribution of funds that can be used to reimburse you for qualified health care expenses. Documentation Requirements Expenses Incurred in a Foreign Country Transportation Expenses Sign In Help. * Use your Via Benefits website login and password. Decide on what kind of signature to create. Eligible retirees enrolled in a medical plan throughVia Benefits (formerly Towers Watsons OneExchange), and retirees enrolled in TRICARE for Life and Medicare Parts A and B, receive a monthly Years of Service contribution to a Health Reimbursement Arrangement (HRA). Read Reimbursement Request Deadlines Explained to learn more. For the previous years Part B premium, the IRS Form 1099 can be used as documentation for the year shown on the form. Speed up your businesss document workflow by creating the professional online forms and legally-binding electronic signatures. Use a via benefits reimbursement request form template to make your document workflow more streamlined. Visit irs.gov to confirm whom you may claim as a dependent. There are 3 types of reimbursement options: automatic premium reimbursements, recurring pre- A joint reimbursement account means you and your spouse share one account. Welcome to Via Benefits This way to personalized benefits for a more secure life for you and your family. Our first priority is you. Get access to thousands of forms. You may also submit a reimbursement request on the website, on theVia Benefits Accounts mobile app, or on a Reimbursement Request Form. Search for the document you need to electronically sign on your device and upload it. One-Time reimbursement requests for premium expenses should be used in limited situations when: You paid in advance for future premiums for a medical insurance annual premium. The Via Benefits program allows flexibility for retirees to customize their Medicare supplemental coverage. Proof of premium payment (e.g., canceled check, bank statement, payment receipt). Both options are more secure and faster than using a paper form. Also, our benefit advisors are trained regarding benefits and coverage for each of the different insurance plans we offer. Read Submit or Cancel a Reimbursement Request for instructions. With signNow, you can eSign as many papers in a day as you need at a reasonable price. Add the PDF you want to work with using your camera or cloud storage by clicking on the. 3. Your Social Security Benefit Award Letter (or Benefit Verification Letter or budget letter) includes all of the required information as supporting documents. Note: Don't submit a Part B Premium reimbursement request if you're currently using Automatic Premium Reimbursement. After we process your request, we begin sending you regular premium reimbursements at the beginning of each month for the remainder of the calendar year. Here are some of the features of the Via Benefits Accounts mobile app. Only your former employer can contribute funds to this account. Look through the document several times and make sure that all fields are completed with the correct information. However, these alerts persist until you complete the requested action. For example, your former employer may require you be enrolled in a medical plan or prescription drug plan through Via Benefits Insurance Services. If youre happy with your plan, keep your plan. Learn about HRAs (health reimbursement accounts) and how they can help you pay out-of-pocket medical expenses, what kinds there are, the benefits and how to enroll. We recommend you get one of the following documents to provide the information above: An Explanation of Benefits (EOB) from your insurance carrier, An itemized statement from your provider. Select View accounts in the Funds & Reimbursements section.3. There's a We found some sections that are missing information alert on the Profile pagewhen you haven't signed up for text alerts. Use signNow to electronically sign and send out My via benefits reimbursement form for collecting e-signatures. Your direct deposit takes effect once your banking information is validated. Select View accounts under Funds and Reimbursements. Monday Friday, 8 a.m. 7 p.m. Eastern Time, Copyright 2022 Extend Health, LLC All Rights Reserved. Your Reimbursement Guide provides more details on reimbursable expenses. You can do the translation and currency conversion yourself. Due to its cross-platform nature, signNow is compatible with any device and any OS. Your direct deposit takes effect once your banking information is validated. Typically, you can't submit reimbursements on your spouses account when you have a separate account. Request a copy of this letter by contacting the Social Security Administration (SSA) at 1-800-772-1213 (TTY: 1-800-325-0778) or going to ssa.gov. Monday Friday, 8 a.m. 7 p.m. Eastern Time, Copyright 2022 Extend Health, LLC All Rights Reserved. Cookies are small text files stored on your . Note: If you receive your Reimbursement Guide and can't see your funding information on the mobile app or website, please contact us. Select Reimbursement Center on the Funds and Reimbursements page.4. Via Benefits reimbursement accounts are administered by Extend Health, LLC. Select Yes, Delete Account in the Delete Bank Account box. Via Benefits makes available Medicare supplemental plans from more than 90 health insurers (carriers) nationwide. For out-of-pocket expenses, such as prescriptions and doctor's office copays, we need third-party documentation that includes all of the following: Amount incurred or charged (not amount paid). * Fingerprint or Touch ID Authentication. Solution Benefits Accounts WTW's Benefits Accounts empower employees and retirees to determine how to use their benefit dollars through flexible, tax-advantaged medical spending and savings accounts, including health savings accounts (HSAs), flexible savings accounts (FSAs) and health reimbursement arrangements (HRAs). Via Benefits - Account Management. For dependant care please attach receipts or have a Tax ID Direct deposit banking information validates within seven business days if submitted on the mobile app or website. You're also given the opportunity after you submit reimbursement requests. Via Benefits administers the HRA for my former employer Northrop Grumman and other corporations. You may also set up direct deposit or update your banking information by returning a completed Direct Deposit Authorization Form. Depending on the situation, funding that has already been placed in your account may also be reversed. Use professional pre-built templates to fill in and sign documents online faster. If you want to share the via benefits reimbursement with other parties, you can easily send the file by electronic mail. Due to its universal nature, signNow is compatible with any device and any OS. You need to enable JavaScript to run this app. 1-800-326-5496 (TTY: 1-800-545-8279) . *Via Benefits reimbursementaccounts are administered by Extend Health, LLC. All of the contributed funds for both you and your spouse, if applicable, go into this shared account. Find the extension in the Web Store and push, Click on the link to the document you want to eSign and select. : , . Because the funds are in a reimbursement account managed by a third party (e.g., Via Benefits) and used only for qualified medical expenses, you don't have to pay any additional taxes on your annual return. 300004-160815-FRMPSH-OneExchange Reimbursement Form PO Guide to Requesting Reimbursement To request reimbursement for your health care premiums use this form. Safe and secure: * Simple user login and registration. All you have to do is download it or send it via email. Go to the Chrome Web Store and add the signNow extension to your browser. signNow makes signing easier and more convenient since it provides users with numerous extra features like Merge Documents, Invite to Sign, Add Fields, and so on. Follow the instructions below to complete Via benefits reimbursement form 2022 online quickly and easily: Sign in to your account. To get to your reimbursement account on the website, follow these steps: 1. Individuals can't add funds to their accounts. To set up direct deposit, follow these steps: 1. They're the fastest and most secure ways to get your reimbursements processed. : . Download your copy, save it to the cloud, print it, or share it right from the editor. 2. Read Submit or Cancel a Reimbursement Request for instructions. You receive your payments by check until your banking information is validated (except as noted above). If you manage your Social Security online, you can provide the information from the website, instead of waiting for the letter. You only need to request reimbursement once per year for each health plan premium you'd like reimbursed unless your premium changes. What solutions are included in the Via Benefits solution suite? If you've chosen people to manage your affairs or help you in the event you become incapacitated or pass away, add them to your Via Benefits profile as authorized representatives. Typically, Via Benefits reaches out to retirees 6-9 months before turning 65. Associate Director of Strategy @ Willis Towers Watson > Benefits, Delivery, & Administration > Individual Marketplace, Monday Friday, 8 a.m. 7 p.m. Eastern Time, Copyright 2022 Extend Health, LLC All Rights Reserved. Your reimbursement request must be submitted with third-party documents that include: Coverage period (e.g., 01/01/2022 - 12/31/2022). We can't sign you in. It employs 251-500 people and has $25M-$50M of revenue. Select View accounts in the Funds & Reimbursements section.3. Following fields. Automatic Premium Reimbursement only reimburses you for the standard Part B premium. Ensure the security of your data and transactions Savings account number and routing number. The account may be used to pay insurance premiums, Medicare Part B premiums and other health care expenses not . Open the doc and select the page that needs to be signed. Sign up with your credentials or register a free account to try the service prior to choosing the subscription. You are eligible to participate in the Retiree Reimbursement Account (RRA) if you meet one of the following conditions: You were a participant in the RRA in the last calendar year, you maintained continuous coverage under an individual medical and/or prescription drug insurance policy purchased through Via Benefits; or To get voice-activated account information, call us, verify your identity, and when prompted, say "options" to hear the automated service options. You can manage how you receive your reimbursement account notifications, such as balance reminders and Explanations of Payment (EOPs). We notify you when you're at risk of losing funding. This takes you to your reimbursement account. Sign into the mobile app using your Via Benefits website username and password.2. Your former employer indicates specific criteria you must meet to qualify for your fundingand determines what expenses are eligible for reimbursement from these funds. You may be able to use Automatic Premium Reimbursement to receive your reimbursements. Via Benefits reimburses you for the premium, up to the available balance in your reimbursement account, according to your chosen reimbursement method. Get access to thousands of forms. Your expenses can include subway,bus, taxi, train, or plane fares,rideshareservices (e.g., Uber,Lyft), ambulance services, parking ortollfees, mileage, and transportation expenses for individuals who must go with the person receiving treatment, like a parent,nurse, or caregiver. There are three variants; a typed, drawn or uploaded signature. Begin signing via benefits reimbursement by means of solution and join the millions of satisfied clients whove previously experienced the key benefits of in-mail signing. This article applies to you if you have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement). A Recurring Premium Reimbursement request needs to be submitted once each calendar year to be reimbursed monthly, or you can submit for a one-time reimbursement of quarterly Medicare Part B payments. Select Reimbursement Center on the Funds and Reimbursements page.4. Your proof of mileage must be kept in a mileage log or similar document. This article applies to you if you have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement).*. They're the fastest and most secure ways to get your reimbursements processed. Browse the board meeting section to view details, download documents and find remote site information. Add the PDF you want to work with using your camera or cloud storage by clicking on the. If you and your spouse have separate reimbursement accounts, you both need to set up direct deposit. You must be enrolled in a Medicare Advantage or a Medicare Supplement Insurance (Medigap) plan through Via Benefits Insurance Services to qualify for Part B Automatic Premium Reimbursement. You can be reimbursed for an out-of-pocket medical expense as long as it's an eligible expense (such as an office visit or prescription copay, dental treatment, hearing aids, etc. 1-800-326-5496 TTY: 1-800-545-8279. Choose My Signature. With signNow, you are able to design as many papers per day as you need at a reasonable price. Create an account using your email or sign in via Google or Facebook. View HRA contributions. If you receive a loss of funding notification from Via Benefits, and the loss of funding wasn't intentional or you believe it has occurred in error, please contact us. You can request reimbursement by submitting a reimbursement request on the Via Benefits Accounts mobile app, on thewebsite, or by submitting a Reimbursement Request Form. In many cases, this means your former employer established requirements to qualify for a reimbursement account, which you no longer meet. Get connected to a strong web connection and begin executing forms with a fully legitimate signature within a few minutes. If you've chosen people to manage your affairs or help you in the event you become incapacitated or pass away, add them to your Via Benefits profile as authorized representatives. Expenses you incur in a foreign country may be eligible for reimbursement, as long as the care is medically necessary. Select Delete Account or select the trash can icon.7. 3. Select Add Bank Account on the Profile page and provide the required information.2. Use our eSignature tool and say goodbye to the old times with affordability, security and efficiency. Mail the form and voided check to the address provided on the form. TM Complete the Direct Deposit Authorization Form. Social Security Number Enter only the last four digits of your Social Security number Reimbursement account access, available on the website or mobile app, and on reimbursement request forms, is in the account holder's name. Having separate reimbursement accounts means you and your spouse each receive a funding contribution and your funds are put into separate accounts. * Save Username on this Browser - Do not check the Save Username option if you are using a public computer, for example in a Library. Via Benefits has a few suggestions to improve your experience while using your reimbursement account, such as updating your notification settings on the website for email and text, automating your premium reimbursement (if it's offered by your plan), and setting up direct deposit. Medical Expense Reimbursement. Read Automatic Premium Reimbursementto learn more. Select Set Up Direct Deposit at the bottom of the Dashboard, or select Sign Up on the last screen after submitting a reimbursement request. Read Direct Deposit for instructions. Additional Employee Benefits May Include the following: Company Paid Retirement Benefit, Employee Stock Purchase Plan, Paid Holidays, Flexible Spending Accounts (FSAs), Health Savings Account (HSA), Time Off and Flexible Days, Group Legal Plan, Group Home Auto Insurance, Pet Insurance, Employee Discounts, Adoption Reimbursement, Tuition Reimbursement and Student Loans, Well-Being Programs, etc This statement cant say insurance pending or estimate., An itemized receipt or ledger from your pharmacy. ATENCIN: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Via Benefits has a few suggestions to improve your experience while using your reimbursement account, such as updating yournotification settings on the website for email and text, automating your premium reimbursement (if it's offered by your plan), and setting up direct deposit. You can also submit a reimbursement request if you provided payment information for aninitial payment with your application. Origin or starting address (usually your home address), Provider's address (where medical care was incurred), Total distance traveled between locations, in miles, Expense recipient (who the expense was for), Requested amount (mileage rate x miles traveled). Need help? Who may request reimbursement from your account is determined by your former employer. Open the email you received with the documents that need signing. For most people, direct deposits are displayed in your bank account as Via Benefits.. Your browser is currently set to block cookies. The company is headquartered in South Jordan, Utah. Manage Your Communications Reimbursement Request Read Access Your Reimbursement Account on the Website to learn how. Employer Name Enter your employer name Select Reimbursement Center on the Funds and Reimbursements page. This article applies to you if you have a Via Benefits reimbursementaccount(sometimes known as a Health Reimbursement Arrangement).*. Llame al 1-800-326-5496 (TTY: 1-800-545-8279) Contact us! You cansign into your account at any time to review your reimbursement account activity. TM Welcome to Via Benefits This way to benefits that fit your needs, with support and advocacy you can trust. Please contact Via Benefits if you have any questions. Use professional pre-built templates to fill in and sign documents online faster. Follow our step-by-step guide on how to do paperwork without the paper. And due to its cross-platform nature, signNow works well on any device, desktop computer or mobile phone, regardless of the OS. Read Authorize Others to Access Your Account for more information. Install the signNow application on your iOS device. If you've chosen people to manage your affairs or help you in the event you become incapacitated or pass away, add them to your Via Benefits account as authorized representatives. Select View accounts in the Funds & Reimbursements section. To take advantage of direct deposit, you must provide Via Benefits with the following information for your checking account or savings account: Checking account number and routing number (as found at the bottom of your checks) and a voided check. The employer may allow: The account holder and any eligible dependents. Select the document you want to sign and click. Gi s 1-800-326-5496 (TTY: 1-800-545-8279) You have two opportunities to set up direct deposit on the mobile app. Whether you set up direct deposit on the website, on the mobile app or on a paper form, you can updateyour banking information on the websitewhenever you want. Provide the required information on the Add Bank Account page. If you're requesting funds be deposited into a checking account, a voided check is also required. Search for "benefit verification letter." Note: You must sign up with Via Benefits if you haven't already. Accepted mileage documents include a printout from an online map service, such as Google Maps, a handwritten document, or an Excel or Word printout. Guided Assistance, Top Searches: Dental | Helping a Family Member | Sign In | Direct Deposit, Your Individual and Family Enrollment Call. They have non-existent customer service for any problem that is not amenable to an automated (or read off a script) response. Start automating your signature workflows right now. You can request reimbursement by submitting a reimbursement request on the Via Benefits Accounts mobile app, on the website, or by submitting a Reimbursement Request Form. Taking the actions described below reduces the number of steps needed for you to receive your reimbursements and reduces the amount of mail you receive from us. Go to your reimbursement account to view your account information. They're the fastest and most secure ways to have your reimbursements processed. Only your former employer can contribute funds to this account. Section II. Direct deposit is faster than getting a check in the mail, provides convenient reimbursement when you're away from home, and is more secure than mailed checks. All Medicare-eligible retirees and dependents select an individual plan with help from a licensed benefit advisor at Via Benefits. After that, your my via benefits funds forms is ready. Monday Friday, 8 a.m. 7 p.m. Eastern Time, Copyright 2022 Extend Health, LLC All Rights Reserved. The Via Benefits Accounts mobile app gives you the power to manage your account (s) anywhere, anytime. The Funds & Reimbursements section might not appear on your Home page if: Funds haven't been loaded into your account, You aren't eligible for a reimbursement account, You're opting for a Premium Tax Credit rather than the HRA (health care). Select the area you want to sign and click. Account Holder Date of Birth Enter your date of birth using format MM/DD/YYYY Select Save. Automatic Premium Reimbursement is an added service offered by Via Benefits for most Medicare health plans, including Medicare Part B. Open Enrollment October 15 December 7, 2022, Medicare Advantage (MA) and Prescription Drug plan (PDP) October 15 December 7, 2022, Medicare Supplemental Insurance (Medigap), dental, and vision anytime of the year; recommended changing after Open Enrollment. We believe the name Via Benefits is a door opener and sets the stage much more effectively for clients to appreciate the full scope of our offerings and the value of our approach. As always, Via Benefits protects your account information. The account is tax free, meaning you don't report it as income or pay taxes on it. To cancel direct deposit, complete these steps: 1. You can download the signed [Form] to your device or share it with other parties involved with a link or by email, as a result. If any previous months were included in your request, you're reimbursed for those months in a lump sum. Until then, we encourage you to call Via Benefits at 1-866-322-2824 (#711) to speak to one of our expert benefit advisors. Sign into Via Benefits. Forms without a barcode aren't processed. 6. With intuitive navigation and a modern look and feel, the mobile app is the smart choice to get the most out of your account. New supporting documents are needed each year. Phone: We have created a simple guide to help you during this difficult time. Any payments made during this time area paper check. The alertpersists until you sign up for text alerts, but it doesn'tprevent you from using your account. Note: You must sign up with Via Benefits if you haven't already. Show details How it works Upload the via benefits reimbursement form Edit & sign via benefits reimbursement from anywhere Save your changes and share my via benefits forms Rate the via reimbursement online 4.8 Satisfied 121 votes A Recurring Premium Reimbursement request needs to be submitted once each calendar year to be reimbursed monthly, or you can submit for a one-time reimbursement of quarterly Medicare Part B payments. Select Reimbursement Center on the Funds and Reimbursements page. Documentation Requirements. : . Popular Searches. Access Your Reimbursement Account on the Website Health Health (5 days ago) WebTo get to your reimbursement account on the website, follow these steps: 1. Go to the Funds and Reimbursements page on the website to find out if Automatic Premium Reimbursement is available for your Medicare Part B premiums. Read Access Your Reimbursement Account on the Websiteto learn how. There are several events that can cause a loss of funding, for example: You stopped paying your premiums, and your health plan was canceled, You canceled your supplemental Medicare coverage and returned to Original Medicare Parts A and B, You enrolled in a health plan with an insurance carrier or independent agent, not Via Benefits, An error occurred with the reporting to Via Benefits, You went back to work and lost eligibility, Your employer changed the eligibility status for your reimbursement account. After entering your username, click Sign In. What is Via Benefits? To understand your options read Authorize Others to Access Your Information, Monday Friday, 8 a.m. 7 p.m. Eastern Time, Copyright 2022 Extend Health, LLC All Rights Reserved, Authorize Others to Access Your Information, We have created a simple guide to help you during this difficult time. CH : Nu bn ni Ting Vit, c cc dch v h tr ngn ng min ph dnh cho bn. Your options for setting up direct deposit are described below. If your former employer hasn't set restrictions on what's reimbursable, read Eligible Medical Expenses Explained to verify what expenses may be eligible. If you set up direct deposit on the website or on the Via Benefits Accounts mobile app, a voided check isn't required. Decide on what kind of eSignature to create. If your employer doesn't allow Recurring Premium Reimbursement, each month you need to submit a reimbursement request, along with proof of payment. This article applies to you if you have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement)*. STEP 2: Under Insurance Premium Expenses, complete the following fields. If you submit a bill from midyear, only the earliest statement month forward will be approved. 4. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our 3rd party partners) and for other business use. Please attach all receipts that apply to requested reimbursements. Individuals can't add funds to their accounts. Go digital and save time with signNow, the best solution for electronic signatures. Provide your banking information, including your bank account number and routing number. Read the Setting Up Direct Deposit on the Mobile App section if you want to set up direct deposit using the mobile app. View Via Benefits (formerly Towers Watson's OneExchange) HRA Presentation (PDF) Begin automating your signature workflows right now. Direct deposit allows reimbursements to be deposited directly into your checking or savings account. Its faster and more secure than receiving a paper check.
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