WebMedicare For people 65+ or those under 65 who qualify due to a disability or special situation Medicaid For people with lower incomes Dual Special Needs Plans (D-SNP) … WebGet the free flex services higginbotham form. Description of flex services higginbotham. REIMBURSEMENT REQUEST FORM Employer Name Guardian Group Policy Number …

Employee Benefits for Businesses - Insurance Broker Higginbotham

WebFax or mail Attn. Flex Department to: c/o Higginbotham 1300 Summit Ave, Ste 750 Fort Worth, TX 76102 Phone: 866-419-3519 Fax: 817-882-9267 Toll-Free Fax: 866-419-3516 … WebHealth Care Spending Account Reimbursement Form Attn. Flex Department c/o Higginbotham 500 W. 13th Street Fort Worth, TX 76102 Phone: 866-419-3519 Fax: 817 … ceftin breastfeeding

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Web7. Custodial Parent Information: For reimbursement requests from a Legal Custodial Parent not on the plan, please provide Name, contact phone # and address payment is to be mailed to: 13. Please attach one of the following proofs of payment: Copy of receipt, provider invoice or statement that indicates the amount paid to the provider and method of WebIf you have a question on which form you should use please call one of our customer service representatives at (888) 472-0777. BASIC HRA Reimbursement Form Employees who do NOT have a BASIC HRA Debit Card use this form to request reimbursement from their BASIC Flex account. Non Debit Card Users (pdf) WebYou will be reimbursed for care received as of that date and documented on the receipts you submitted, up to the dollar amount you have available in your Dependent Care FSA. Make sure to sign up for direct deposit to get your funds fast—they’re electronically deposited in your savings or checking account. ceftin bactrim