State Of Florida Employee Medical Reimbursement Account Forms

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Forms / Health | MyBenefits / Department of …

https://www.mybenefits.myflorida.com/health/forms

Healthcare Spending Account Claim Form (757.91 KB) Dependent Care FSA Claim Form (980.47 KB) Post–Deductible HRA Verification Form (728.83 KB) FSA Options When …

Savings and Spending Accounts / Health | MyBenefits

https://www.mybenefits.myflorida.com/health/savings_and_spending_accounts

HRA money is used to pay for eligible medical, dental, vision, preventive and prescription drug expenses. Use the Benefit Card to pay for eligible services and items; Pay your …

Health Reimbursement Account Frequently Asked …

https://www.mybenefits.myflorida.com/content/download/142749/952554/Approved_SOF_HRA_FAQ_10-4-18.pdf

The Health Reimbursement Account (HRA) is an employer-funded plan that reimburses employees for medical expenses not covered by company-sponsored insurance. The …

Forms / For State Personnel System HR Practitioners / …

https://www.dms.myflorida.com/workforce_operations/human_resource_management/for_state_personnel_system_hr_practitioners/forms

SES Extraordinary Payment Plan - Template [Rev. 3-26-18] ( 34.00 KB) State Employee Tuition Waiver Program: (template) State Employee Tuition Waiver …

Contact Us / State Group Insurance / Workforce …

https://www.dms.myflorida.com/workforce_operations/state_group_insurance/contact_us

Mail Medical Reimbursement Account payments to: Division of State Group Insurance FSA/HRA Accounts P.O. Box 7434 Tallahassee, FL 32314-7434 Scan Medical and …

State of Florida Claim Reimbursement Form

https://www.mybenefits.myflorida.com/content/download/122936/667169/sof_fsa_claim_reimbursement_form123015.pdf

Flexible Spending Account Claim Reimbursement Instructions 1. Complete all information on the front page (please print/type). 2. Attach supporting documentation. A copy of a …

Health Savings Account / Savings and Spending …

https://www.mybenefits.myflorida.com/health/savings_and_spending_accounts/health_savings_account

A Health Savings Account (HSA) is an account associated with the high deductible HMO and PPO plans that allow you to use pretax dollars to pay your share of the cost for …

Employee Login, State of Florida Employee Information Center

https://apps.fldfs.com/EIC/EmployeeInfoCenter/

Welcome to the State of Florida Employees' Information Center This site will provide you the ability to make inquiries into your payroll information, W-4 information, …

State of Florida Travel Guidelines - Florida …

https://www.floridahealth.gov/provider-and-partner-resources/research/grant-programs-resources/StateofFloridaTravelGuidelines.pdf

claimed for reimbursement. 2. Address – Enter the address, city, state, zip code and bin number. Travel of 24 hours or more away from the traveler’s 3. Check One – Mark the …

Travel Forms - Florida

https://www.dms.myflorida.com/content/download/50584/214745/version/5/file/FMS-103-DFS-AA-15+-+Voucher+Reimbursement+of+Travel+Expenses+2-08.xls

travel expenses which may be reimbursed include: (a) reasonable taxi fare; (b) ferry fares and bridge, road, and tunnel tolls; (c) storage and parking fees; (d) telephone and …

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