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HealthInvest HRA

 

Participant Forms


Medical Reimbursement Form

 

Premium Reimbursement Form

 

IRS Publication 502

 

 

IMPORTANT: Required Documentation


The Trust Office may pay a claim for benefits upon receipt of documentation, prepared by a third party independent from the Beneficiary, showing each of the following items:

 

  1. The date of medical services, which were provided prior to the date of the claim;

  2. The type of medical services, meeting the Plan definition of Covered Expenses in Section 1.10(b); and

  3. Proof of the Beneficiary's payment for the medical services.