Security Benefit: To and Through Retirement 2026

1. Click ‘Get Form’ to open the Security Benefit: To and Through Retirement form in the editor.
2. Begin by providing your personal information in Section 1. Fill in your Employer Group Name, Social Security Number, and Employee Name. Ensure that you include your mailing address and check the box if your address has changed.
3. In Section 2, detail your insurance premium reimbursement. Specify the Policy Holder, Description of Policy, Policy Period, Reimbursement Start and End Dates, Amount Requested, Frequency of payment, and where to send the payment.
4. For Section 3, choose your preferred form of payment for medical reimbursements. You can opt for direct deposit or a mailed check. If selecting direct deposit, provide your bank details accurately.
5. In Section 4, sign and date the form to confirm that you understand the requirements for reimbursement claims.
6. Finally, complete Section 5 by summarizing itemized medical bills for eligible expenses incurred within one year. Attach any necessary documentation before submission.

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