Select the area you want to sign and click. After its signed its up to you on how to export your via benefits reimbursement: download it to your mobile device, upload it to the cloud or send it to another party via email. Get access to thousands of forms. The signNow extension was developed to help busy people like you to reduce the stress of putting your signature on papers. Popular Searches. Asavings deposit slip may not have all the necessary information. Account Holder Full Name Enter your last name, first name and middle initial The reimbursement account may no longer receive funds to pay for your health care expenses. : 1-800-326-5496 (TTY: 1-800-545-8279) 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. TM Welcome to Via Benefits This way to benefits that fit your needs, with support and advocacy you can trust. Read more about Reimbursement best practices: Manage Your Reimbursement Account, Understand Your Reimbursement Account, and Access Your HRA, Anytime, Anywhere. To get to your reimbursement account, follow these steps: Sign in to your Via Benefits account. It employs 251-500 people and has $25M-$50M of revenue. 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. Read Submit or Cancel a Reimbursement Request for instructions. Get connected to a strong web connection and begin executing forms with a fully legitimate signature within a few minutes. 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 Provide the required information on the Add Bank Account page. Decide on what kind of eSignature to create. 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. Setting up direct deposit doesn'tgive our employees access to your banking information. Mail the form and voided check to the address provided on the form. Your Reimbursement Guide provides more details on reimbursable expenses. On the Dashboard, select your name and then select Banking Information.5. There are other ways to submit a reimbursement request if Automatic Premium Reimbursement isn't available to you. * Fingerprint or Touch ID Authentication. : , . If you and your spouse have separate reimbursement accounts, you both need to set up direct deposit. Via Benefits administers the HRA for my former employer Northrop Grumman and other corporations. Reimbursement Request Include documents from your bank with routing and account numbers. If you submit a bill from midyear, only the earliest statement month forward will be approved. 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 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. Employee E-mail Address: *Via Benefits reimbursementaccounts are administered by Extend Health, LLC. We can't sign you in. If you want to share the via benefits reimbursement with other parties, you can easily send the file by electronic mail. With signNow, you are able to design as many papers per day as you need at a reasonable price. How to Navigate Your Via Benefits Dashboard 3,150 views Jan 5, 2021 13 Dislike Share Save OhioPERS1 1.56K subscribers This video is a short tutorial of how to navigate the Via Benefits. Learn more: Submitting or Cancelling a Reimbursement. 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. Sign into your Via Benefits account. Using automatic reimbursement, your insurer will draft your premium payments directly from your bank account and submit your request for premium reimbursement to Via Benefits automatically. Cost Savings 6. ACERA provides the funds for your HRA. Provide the required information on the Add Bank Account page.7. Follow our step-by-step guide on how to do paperwork without the paper. 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. Sign up with your credentials or register a free account to try the service prior to choosing the subscription. The whole procedure can take a few moments. 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. Your former employer also determines if funds remaining in your account at the end of the yearroll over to the next year. This article applies to you if you have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement). 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'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. Fermilab provides a subsidy of $175/month, per person, funded to a Health Reimbursement Account (HRA). Contact Us Save time and postage by submitting reimbursement requests on the Via Benefits Accounts mobile app or website. : . Use professional pre-built templates to fill in and sign documents online faster. For example, your former employer may require you be enrolled in a medical plan or prescription drug plan through Via Benefits Insurance Services. Speed up your businesss document workflow by creating the professional online forms and legally-binding electronic signatures. Note: Effective September 1, 2020, only Direct Deposit Authorization Forms with a barcode are accepted. If you set up direct deposit on the website or on the Via Benefits Accounts mobile app, a voided check isn't required. You can do the translation and currency conversion yourself. Draw your signature or initials, place it in the corresponding field and save the changes. (TTY: 1-800-545-8279) 1-800-326-5496 . 2. Vice President, Client Accounts, Exchange Solutions @extendhealth.com It may take up to 20 business days to receive and validate your Direct Deposit Authorization Form. You may also submit a reimbursement request on the website, on the Via Benefits Accounts mobile app, or on a Reimbursement Request Form. 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. 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. Sign into your Via Benefits account.2. Get Form How to create an eSignature for the via benefits reimbursement form 2021 Note: For help locating your banking information, select the?next toAccount Number. Install the signNow application on your iOS device. 4. 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. Learn how to create an account. You have two opportunities to set up direct deposit on the mobile app. Follow the instructions below to complete Via benefits reimbursement form 2022 online quickly and easily: Sign in to your account. 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. 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. Both options are more secure and faster than using a paper form. Refer to IRS issues standard mileage rates for 2022 for more details. Use professional pre-built templates to fill in and sign documents online faster. Your reimbursement request must be submitted with third-party documents that include: Coverage period (e.g., 01/01/2022 - 12/31/2022). Printing and scanning is no longer the best way to manage documents. 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. Via Benefits is not an insurance company; it is a resource that gives you access to a state-of-the-art Medicare exchange (sometimes referred to as a marketplace) containing a wide Your Reimbursement Guide provides more details on reimbursable expenses. 2. With intuitive navigation and a modern look and feel, the mobile app is the smart choice to get the most out of your account. Get access to thousands of forms. Once youve finished signing your via benefits reimbursement, choose what you want to do next save it or share the doc with other people. They're the fastest and most secure ways to get your reimbursements processed. Search for the document you need to electronically sign on your device and upload it. Read Access Your Reimbursement Account on the Website to learn how. You can set it up whenever you'd like from the Dashboard. We recommend setting up direct deposit on the website or on the mobile app. 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. Learn About the Basics of Individual and Family Coverage. Read Automatic Premium Reimbursementto learn more. 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. There are 3 types of reimbursement options: automatic premium reimbursements, recurring pre- 9. 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 they were to issue a check to you each month instead, it would be taxable income. Draw your signature or initials, place it in the corresponding field and save the changes. We notify you when you're at risk of losing funding. This article applies to you if you have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement).*. Section II. The Via Benefits Accounts mobile app gives you the power to manage your account (s) anywhere, anytime. Reimbursement account access, available on the website or mobile app, and on reimbursement request forms, is in the account holder's name. via benefits reimbursement account my via benefits via benefits phone number opers via benefits login Create this form in 5 minutes! . The annual policy statement or billing statement, sent to you by your insurance carrier, usually provides the required information. 1. For dependant care please attach receipts or have a Tax ID Get access to thousands of forms. An health reimbursement arrangement (HRA), sometimes called a health reimbursement account, is a type of health care account, not an insurance plan, which is funded entirely by your employer; employees cannot contribute to an HRA. You want to be reimbursed for premiums paid under COBRA. Select Add Bank Account.6. If you wish to share the my via benefits funds forms with other parties, you can send the file by e-mail. The balance reflects the current available funds for both of you together. Select View accounts in the Funds & Reimbursements section.3. Expenses you incur in a foreign country may be eligible for reimbursement, as long as the care is medically necessary. Llame al 1-800-326-5496 (TTY: 1-800-545-8279) Submit your reimbursement requests on the Via Benefits Accounts mobile app or on the website. 1. Please contact Via Benefits if you have any questions. Open the email you received with the documents that need signing. 1-866-322-2824 (TTY: 711) Mon-Fri 8am - 7pm Eastern We need the first month's bill for which you want to be reimbursed. Select Reimbursement Center on the Funds and Reimbursements page. 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. Your browser is currently set to block cookies. You can be reimbursed for your standard Medicare Part B premium amount if its allowed by your former employer or benefits provider. Multiple documents can be submitted to provide the required information if it isn't located on the policy or billing statement. You need to submit a new Recurring Premium Reimbursement request each time your plan renews, which is typically 12 months after the plan went into effect. For example, if you submit a March statement, January and February won't be approved. Medical Expense Reimbursement. Plans renew automatically, but premiums may increase. These alerts don't prevent you from using your account. You cansign into your account at any time to review your reimbursement account activity. Open the doc and select the page that needs to be signed. If your employer allows it, Recurring Premium Reimbursement can be established for eligible premiums, paid to any insurance carrier. 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. Sign In Help. What is Via Benefits? Review the Public Employee Benefits Program Nondiscrimination Statementhere. Who may request reimbursement from your account is determined by your former employer. Create your eSignature, and apply it to the page. Documentation Requirements. Payments by check are held until the amount is greater than $25; however, if you establish direct deposit, the minimum payment is $1. You need to enable JavaScript to run this app. Select our signature solution and leave behind the old days with affordability, efficiency and security. Read Choose Your Medicare Coverage, Medicare Part A Overview or Medicare Part B Overview. The best way to create an signature for a PDF document in the online mode, The best way to create an signature for a PDF document in Chrome, The best way to generate an signature for putting it on PDFs in Gmail, The best way to generate an electronic signature straight from your mobile device, The way to generate an signature for a PDF document on iOS devices, The best way to generate an electronic signature for a PDF document on Android devices, If you believe that this page should be taken down, please follow our DMCA take down process, You have been successfully registeredinsignNow. If you have not heard from them and you are approaching age 65, feel free to contact them at (866) 249-7784. Eligible retirees may use the HRA money for reimbursement of the following: HRA funds may be used to reimburse health care expenses (including medical, dental, vision, and Medicare Part B premiums) for both the retiree and their eligible tax dependents as defined by IRS Publication 502 available atwww.irs.gov. Read Access Your Reimbursement Account on the Websiteto learn how. For COBRA, you can submit your COBRA Premium Statement showing insurance details and covered participants. Built for busy lives: * Check an account balance on the go. Provide your banking information, including your bank account number and routing number. Select Save. Select Reimbursement Center on the Funds and Reimbursements page.4. Individuals can't add funds to their accounts. A joint reimbursement account means you and your spouse share one account. *Via Benefits reimbursement accounts are administered by Extend Health, LLC. You're also given the opportunity after you submit reimbursement requests. The employer may allow: The account holder and any eligible dependents. Current UMC retirees and their spouses have selected over 1,000 different plans that meet their individual needs. Forms without a barcode aren't processed. This statement cant say insurance pending or estimate., An itemized receipt or ledger from your pharmacy. The signNow application is equally as productive and powerful as the online app is. All communications regarding your reimbursement account are addressed in the name of the account holder. Monday Friday, 8 a.m. 7 p.m. Eastern Time, Copyright 2022 Extend Health, LLC All Rights Reserved. 1-800-326-5496 (TTY: 1-800-545-8279) Due to its universal nature, signNow is compatible with any device and any OS. Add the PDF you want to work with using your camera or cloud storage by clicking on the. Open the email you received with the documents that need signing. 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. You each submit your reimbursement requests through your own account. You can also submit a reimbursement request if you provided payment information for aninitial payment with your application. To set up direct deposit on the mobile app, complete these steps: 1. Its faster and more secure than receiving a paper check. View Via Benefits (formerly Towers Watson's OneExchange) HRA Presentation (PDF) Via Benefits manages your HRA because they have the administrative capability to work with hundreds of types of healthcare plans. 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 There are three variants; a typed, drawn or uploaded signature. There's a We found some sections that are missing information alert on the Profile pagewhen you haven't signed up for text alerts. If you sign up for direct deposit, all reimbursements from a joint account go into the same bank account (selected by you). If you manage your Social Security online, you can provide the information from the website, instead of waiting for the letter. 5. are paid to you out of a Health Reimbursement Account (HRA) at Via Benefits. If you need to set up direct deposit, you can do soon the Via Benefits Accounts mobile app or on the website. Get the best care possible and minimize your out-of-pocket expenses by accessing services from an in-network provider. 1-6945-623-800 ( : 1-9728-545-800). The amount of the expense must be converted from the foreign currency to US dollars. Go digital and save time with signNow, the best solution for electronic signatures. 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. For example, Form 1099 dated 2021 can only be used to get reimbursed for 2021 Part B premiums. We want to be sure the process of securing high-quality health benefits through the State of Nevada is as easy as possible. On the Dashboard, select your name and then select Banking Information. Proof of premium payment (e.g., canceled check, bank statement, payment receipt). : 1-800-326-5496 ( :1-800-545-8279). Open the doc and select the page that needs to be signed. Sign into your Via Benefits account.2. 2023 airSlate Inc. All rights reserved. When Part B premiums are an eligible expense, the standard Part B premium is reimbursed monthly, dependent on your enrollment in a Medicare medical plan with Via Benefits. 7. You may be able to use Automatic Premium Reimbursement to receive your reimbursements. You also need to submit a new request if your premium changes during the year, even if you have the same plan. This article applies to you if you have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement).*. 1-800-326-5496 (TTY: 1-800-545-8279) . HRA funds may be used to reimburse health care expenses (including medical, dental, vision, and Medicare Part B premiums) for both the retiree and their eligible tax dependents as defined by IRS Publication 502 available at www.irs.gov. Your Reimbursement Guide provides more details on reimbursable expenses. 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. You only need to request reimbursement once per year for each health plan premium you'd like reimbursed unless your premium changes. Select View Accounts in the Funds and Reimbursements section. To getto your reimbursement account on the website,follow these steps: 1. Monday Friday, 8 a.m. 7 p.m. Eastern Time, Copyright 2022 Extend Health, LLC All Rights Reserved. The individual serviced is the person for whom the expense was incurred. Due to its cross-platform nature, signNow is compatible with any device and any OS. Sign into your Via Benefits account.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 also submit a reimbursement request on the website, on theVia Benefits Accounts mobile app, or on a Reimbursement Request Form. 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. 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. They're the fastest and most secure ways to have your reimbursements processed. Download your copy, save it to the cloud, print it, or share it right from the editor. Only your former employer can contribute funds to this account. Follow the step-by-step instructions below to design your my viabenefits com funds direct deposit form: Select the document you want to sign and click Upload. 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. You may also set up direct deposit or update your banking information by returning a completed Direct Deposit Authorization Form. Former employers, voluntary employees' beneficiary association (VEBA) trusts and state benefit connectors often choose to provide a reimbursement account to their retirees because it's a tax-free account. After you'veset updirect deposit for your reimbursement account, please allow up to three business days after a reimbursement request is approved to receive your funds. Use our eSignature tool and say goodbye to the old times with affordability, security and efficiency. Select the area you want to sign and click. 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). It is designed to reimburse an employee for eligible medical expenses as defined under IRS Code 213 (d). Create your signature and click Ok. 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). The signNow application is just as productive and powerful as the online app is. Your direct deposit takes effect once your banking information is validated. There are three variants; a typed, drawn or uploaded signature. Validation takes up to seven business days if entered through the mobile app or website. Select the area where you want to insert your signature and then draw it in the popup window. Connect to a strong connection to the internet and start executing forms with a fully legitimate electronic signature within a few minutes. On the Dashboard, select your name and then select Banking Information.5. Search for "benefit verification letter." After that, your via benefits reimbursement is ready. Use a via benefits reimbursement request form template to make your document workflow more streamlined. Select Add Bank Account. Select Reimbursement Center on the Funds and Reimbursements page.4. Selecting email reduces the amount of paper you receive. However, these alerts persist until you complete the requested action. * Submit new reimbursement requests. Via Benefits is a company that is experienced in helping retirees evaluate and enroll in Medicare supplemental insurance. Your reimbursement request must be submitted with third-party documents that include: For the previous years Part B premium, the IRS Form 1099 can be used as documentation for the year shown on the form. *Via Benefits reimbursement accounts are administered by Extend Health, LLC. Manage Your Communications Select Reimbursement Center on the Funds and Reimbursements page. Direct deposit allows reimbursements to be deposited directly into your checking or savings account. Once you receive your Via Benefits Reimbursement Guide, take the following actions to prepare for when your reimbursement account becomes effective. The primary participant is the account holder. Guided Assistance, Top Searches: Dental | Helping a Family Member | Sign In | Direct Deposit, Your Individual and Family Enrollment Call. Health Reimbursement Arrangement (HRA) An HRA is an account funded by OPERS that provides tax-free reimbursement for qualified medical expenses such as monthly post-tax insurance premiums, deductibles, co-insurance, and copays incurred by eligible benefit recipients and their dependents. Provide all of the requested information and selectAdd Bank Account. Select View accounts under Funds & Reimbursements. With signNow, you can eSign as many papers in a day as you need at a reasonable price. Monday Friday, 8 a.m. 7 p.m. Eastern Time, Copyright 2022 Extend Health, LLC All Rights Reserved. *Via Benefits reimbursement accounts are administered by Extend Health, LLC. Go to your reimbursement account to view your account information. 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