FSA / HRA Claim Form - Monroe County, New York

FSA/HRA Claim Form is a legal document that was released by the Department of Human Resources - Monroe County, New York - a government authority operating within New York. The form may be used strictly within Monroe County.

FAQ

Q: What is the FSA/HRA Claim form?A: The FSA/HRA Claim form is a document used in Monroe County, New York to request reimbursement for eligible expenses from a flexible spending account (FSA) or a health reimbursement arrangement (HRA).

Q: How do I use the FSA/HRA Claim form?A: To use the FSA/HRA Claim form, fill out your personal information, provide details of the expenses you are seeking reimbursement for, attach any required supporting documentation, and submit the completed form to the designated authority.

Q: What expenses can be claimed on the FSA/HRA Claim form?A: Eligible expenses that can be claimed on the FSA/HRA Claim form include medical and dental expenses, prescription medications, qualified dependent care expenses, and other eligible healthcare costs as defined by the specific FSA or HRA plan.

Q: How long does it take to receive reimbursement after submitting the FSA/HRA Claim form?A: The time frame for reimbursement varies depending on the specific FSA or HRA plan. It is best to consult your plan documents or contact the designated authority for more information on expected processing times.