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The most current form is always available on the Trust website Versions older then 2010 are no longer acceptable. The date of the form will be found at.

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Presentation on theme: "The most current form is always available on the Trust website Versions older then 2010 are no longer acceptable. The date of the form will be found at."— Presentation transcript:

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2 The most current form is always available on the Trust website Versions older then 2010 are no longer acceptable. The date of the form will be found at the bottom right hand corner PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org

3 Retiree Name Current Contact Information PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org Please make sure we have your current e- mail address. It's an important method of communication with you. Check this box if you have a new address. Make sure we can notice it.

4 Date of Service Name Of Patient Total Amount of Expense If applicable, amount insurance covered, any discounts applied Patients responsibility Retiree Signature and Date Filling Out Your Reimbursement Forms (continued) PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org Date the service was actually provided. Statement date or payment date only OK if service date not available. Joe Retiree

5 Prescriptions o Must Include: Drug name Cost Date Patients name o Examples Pharmacy stubs or print out Over the counter drugs with Dr. prescription only o Will not accept: Cash register receipt or payment confirmation alone. PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org

6 Cash Register Receipts Alone is Not Sufficient

7 Bills o Must include: Date of service Patients name Description of what service or product was purchased Any payment transactions o Will not accept: Cash register receipt or payment confirmation alone. PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org

8 Balance forward does not describe service provided. Proof must indicate what product or service was purchased

9 The following expenses are currently eligible as of 2011 : o Lasik eye surgery o Dental implants o Viagra o Cialis o Or anything that meets with the current IRS guidelines PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org It still might be eligible for reimbursement

10 Premiums are eligible for reimbursement but they are subject to aged base annual reimbursement limit. Following are the reimbursement limits for 2011. Attained age before the close of Max reimbursement for year of the taxable year o 40 or less$340 o More than 40 but not more than 50$640 o More than 50 but not more than 60$1,270 o More than 60 but not more than 70$3,390 o More than 70$4,240 PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org

11 o Please make sure not to submit anything to the Trust until it has been fully processed by your insurance. o You may submit reimbursement claims no later then 365 days after the end of the calendar year in which the expense is incurred. o Remember you can only get reimbursed for an expense once. Do not submit the same expense more then once. PO Box 196650 Anchorage, AK 99519-9980 Fax: (907) 249-7622 Email: bretzld@muni.org

12 P.O. Box 196650 Anchorage, AK 99519-9980 Office: (907) 267-5094 Fax: (907) 249-7622 Email: bretzld@muni.org


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