Dependent Care Reimbursement Account Request form - UMR 2025

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The main benefit of an FSA is that the money set aside in the account is in pretax dollars, thus reducing the amount of your income that is subject to taxes. For someone in the 24% federal tax bracket, this income reduction means saving $240 in federal taxes for every $1,000 spent on dependent care with an FSA.
How to submit claims in 2 steps Sign in to your health plan account to find your submission form. Sign in to your member account and go to the Claims Accounts tab, then select the Submit a Claim tab. Submit your claim by mail.
How to Raise a Reimbursement Health Insurance Claim Intimate the insurance company. Pay bills and collect documents. Submit the claim form and documents. Let the insurance company verify and enquire.
Youre only able to enroll in a DC-FSA if your workplace includes it as part of your employee benefits package. If thats the case, you can sign up during open enrollment or after a qualifying life event (QLE). You just have to decide how much to contribute, while following contribution limits set by the government.
You can file claims online or fax completed claim form supporting documentation toll free to 877-390-4782. You can also mail the completed form supporting documentation to: UMR / PO Box 8022 / Wausau WI 54402-8022.
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Claims are processed within two business days, and you can choose to be reimbursed through direct deposit or by having a check mailed to you. There is no fee to you if you choose to have the money directly deposited into your bank account.

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