1-800-326-5496 TTY: 1-800-545-8279. Only your former employer can contribute funds to this account. You can request reimbursement by submitting a reimbursement request on the Via Benefits Accounts mobile app, the website, or a Reimbursement Request Form. If you need an item or service Original Medicare doesn't cover, you're responsible for the full cost unless you have additional insurance that offers appropriate coverage. Get access to a HIPAA and GDPR compliant service for maximum simpleness. 2. Cookies are small text files stored on your . 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. You need to allow cookies to use this service. If your employer allows it, Recurring Premium Reimbursement can be established for eligible premiums, paid to any insurance carrier. 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. Select Save. Mail the form and voided check to the address provided on the form. 3. * Use your Via Benefits website login and password. If you want to share the via benefits reimbursement with other parties, you can easily send the file by electronic mail. 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 your plan doesn'tparticipate in Automatic Premium Reimbursement, consider activating Recurring Premium Reimbursement, which requires you to submit only one reimbursement request each calendar yearunless your premium changes. 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. 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. This article applies to you if you have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement).*. Follow the instructions below to complete Via benefits reimbursement form 2022 online quickly and easily: Sign in to your account. Proof of premium payment (e.g., canceled check, bank statement, payment receipt). Contact us! Also,your transportation expenses (except for mileage and parking meters) must have receipts or statements that include the expense amount, dates, provider, and address to and from. Your former employer also determines if funds remaining in your account at the end of the yearroll over to the next year. Speed up your businesss document workflow by creating the professional online forms and legally-binding electronic signatures. The account may be used to pay insurance premiums, Medicare Part B premiums and other health care expenses not . 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. 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. Provide all of the requested information and selectAdd Bank Account. We have created a simple guide to help you during this difficult time. 6. If you manage your Social Security online, you can provide the information from the website, instead of waiting for the letter. For the previous years Part B premium, the IRS Form 1099 can be used as documentation for the year shown on the form. Thesummary plan description provided by your former employer mayprovide moreinformation abouttheaccount. Read Reimbursement Request Deadlines Explained to learn more. You can also use a Reimbursement Request Form; however, it may take as much as 10 days longer for us to receive and process your request. Learn more: Submitting or Cancelling a Reimbursement. If you choose not to take advantage of automatic reimbursement, or if your insurance carrier does not offer automatic reimbursement, you may send your Go to your reimbursement account to view your account information. Note: You must create an account if you haven't already. Save time and postage by submitting reimbursement requests on the Via Benefits Accounts mobile app or website. Install the signNow application on your iOS device. You may see alerts reminding youto setup direct deposit or text alerts. This allows us to speak to them if you're unable to manage your information. It doesn't need to be a formal translation. ACERA provides the funds for your HRA. The whole procedure can take a few moments. 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). Sign into the mobile app using your Via Benefits website username and password.2. You may also submit a reimbursement request on the website, on theVia Benefits Accounts mobile app, or on a Reimbursement Request Form. The signNow application is equally as productive and powerful as the online app is. Our first priority is you. Direct deposit allows reimbursements to be deposited directly into your checking or savings account. Monday Friday, 8 a.m. 7 p.m. Eastern Time, Copyright 2022 Extend Health, LLC All Rights Reserved. Begin automating your signature workflows right now. View HRA contributions. 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.) Select the area where you want to insert your eSignature and then draw it in the popup window. Vice President, Client Accounts, Exchange Solutions @extendhealth.com Reimbursement Request Nevada Division of Public & Behavioral Health, Basic Life Insurance, the MAP & Travel Assistance, View Via Benefits (formerly Towers Watsons OneExchange) FAQs, Qualified out-of-pocket health care expenses for medical, dental, and pharmacy expenses. 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. The form is available by calling us and using our automated voice system or by speaking with a Via Benefits representative. Tumawag sa 1-800-326-5496 (TTY: 1-800-545-8279) Create your eSignature, and apply it to the page. Forms without a barcode aren't processed. Any payments made during this time area paper check. Your reimbursement request must be submitted with third-party documents that include: Coverage period (e.g., 01/01/2022 - 12/31/2022). Read Update your Reimbursement Notification Settings to learn more. On the Dashboard, select your name and then select Banking Information. Note: Effective September 1, 2020, only Direct Deposit Authorization Forms with a barcode are accepted. 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. If your former employer hasn't set restrictions on what's reimbursable, read Eligible Medical Expenses Explained to verify what expenses may be eligible. Submit your reimbursement requests on the Via Benefits Accounts mobile app or on the website. To getto your reimbursement account on the website,follow these steps: 1. If you haven't already done so, create an account on the Via Benefits Accounts mobile appor on our website, set up direct deposit, and set your notification preferences. Individuals can't add funds to their accounts. 1-866-322-2824 (TTY: 711) Mon-Fri 8am - 7pm Eastern You can be reimbursed for your monthly plan premiums in one of two ways, Recurring Premium Reimbursement or One-Time reimbursement. Contact Us : 1-800-326-5496 ( :1-800-545-8279). Find the extension in the Web Store and push, Click on the link to the document you want to eSign and select. If the supporting documentation is in a foreign language, the five required elements (provider name, participant name, date of service, type or description of service or product, and document showing the participants financial responsibility) must be translated in to English. Open the email you received with the documents that need signing. With signNow, you can eSign as many papers in a day as you need at a reasonable price. View Via Benefits (formerly Towers Watson's OneExchange) HRA Presentation (PDF) TM Welcome to Via Benefits This way to benefits that fit your needs, with support and advocacy you can trust. There are three variants; a typed, drawn or uploaded signature. Accepted mileage documents include a printout from an online map service, such as Google Maps, a handwritten document, or an Excel or Word printout. Decide on what kind of eSignature to create. What is Via Benefits? 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. When a loss of funding occurs, it means Via Benefits has received notification you may not be meeting your former employers requirements, which causes the funding amount to change. The company is headquartered in South Jordan, Utah. 4. All of your transportation expenses must have a corresponding expense for medical care, such as an Explanation of Benefits (EOB)or an itemized statement from your provider. Setting Your Notification Preferences Your notification settings allow you to choose how you receive Via Benefits communications about your reimbursement account (email or paper). *Via Benefits reimbursement accounts are administered by Extend Health, LLC. Read Submit or Cancel a Reimbursement Request for instructions. Sign In Help. Direct deposit banking information validates within seven business days if submitted on the mobile app or website. Decide on what kind of signature to create. You may also set up direct deposit or update your banking information by returning a completed Direct Deposit Authorization Form. 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 These alerts don't prevent you from using your account.
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