Flexbenefits healthgram com 2026

1. Click ‘Get Form’ to open the Flexible Benefit Reimbursement Claim Form in our editor.
2. Begin by entering your Company Name and Employee Name in the designated fields. Ensure that your name is printed clearly for accurate processing.
3. Input your 9-Digit ID# found on your ID card. This is crucial for identifying your account.
4. In the 'Request for Medical Expense Reimbursement' section, fill in the Date Expense Incurred, Name of Service Provider, and a brief Expense Description.
5. Attach any corresponding receipts or Explanation of Benefits from your insurance plan directly within the editor for easy submission.
6. Indicate the Person for Whom the Expense was Incurred and enter the Net Amount of each expense.
7. Finally, review all entries, sign in the Employee Certification section, and date it before submitting your claim.

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