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Click ‘Get Form’ to open the ibm shap in the editor.
Begin with Part I: General Information. Fill in your name, date of birth, and Social Security Number. If applicable, provide details for your spouse or child.
Move to Part II: Other Coverage. Indicate if you receive reimbursements from other sources and attach any necessary documentation.
In Part III: SHAP Medicare B Premium Reimbursement Request, specify the year and quarters for which you are requesting reimbursement for yourself and eligible dependents.
Complete Part IV by certifying that all information is accurate and sign the form. Ensure it is dated.
Finally, review all sections for completeness before submitting the form to the Acclaris Reimbursement Center as instructed.
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IBM has a competitive benefits program designed to support employees and their families across all dimensions of health: physical, mental, social and financial. Benefits vary from country to country.
What is IBM shap reimbursement?
The IBM SHAP Reimbursement Request Form is a document used by employees to request reimbursement for eligible expenses related to the IBM SHAP (Special Health Assistance Program) benefits.
What is shap reimbursement?
Special Health Assistance Provision (SHAP) Reimbursement Request Form. Use this form to submit reimbursement requests for the Special Health Assistance Provision of the IBM Medical Plan. Parts IV are to be completed by the employee, retiree, or eligible surviving spouse.
Does IBM offer tuition reimbursement?
For eligible retirees, IBM offers a premium subsidy in the form of a Health Reimbursement Arrange (HRA). The amounts in the HRA are tax-free and can be used to reimburse yourself for insurance premiums and eligible out-of-pocket expenses, including deductibles, co-pays, and co-insurance.
shap form
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