How Do I File for Reimbursements?

There are two ways to receive reimbursement of funds from your flexible spending account(s): You may submit manual claims (i.e. traditional paper claims) or use your Benefit Card. Use S & A’s Benefit Card Submittal of Receipts Form to submit claims for purchases made using the Benefit Card. Use S & A’s Manual Claim for Reimbursement Form to submit receipts when requesting reimbursement of personal funds used.

Instructions for filing claims for reimbursement using manual claims:

• Complete the Manual Claim Form, remembering to indicate the company you work for, provide your Social Security Number and sign the form at the bottom.
  *Important Note: We are unable to legally process your claim for reimbursement if the claim form is unsigned. Therefore please be sure to sign your form before sending it to our office.
  
• Before sending the claim to the address below, be sure to attach any bills, receipts or Explanation of Benefits (EOBs) to verify expenses listed. Claims can also be faxed to us at (603) 621-9701. If you fax your claims, please be sure the receipts are legible. Send claims to:
  
  S & A, INC.
  50 Elm Street
  Manchester , NH 03101

• The Plan Administrator will then verify that all submitted claims are eligible. If there is any question of eligibility, an S & A administrator will contact you.
  
• Every effort is made to process manual claims on a weekly basis.

Instructions for filing claims using your Benefit Card: 

• Use your Benefit Card at eligible vendors, including most pharmacies, doctors’ offices and hospitals. Swipe the card at the point of sale as if you were using a personal credit card. There is no need to enter a pin; the card is verified by signature.
  
• Complete the Benefit Card Submittal of Receipts Form and attach the receipts that correspond to your Benefit Card purchase(s). Please remember to ALWAYS submit your receipts to
  S & A, Inc., as the IRS requires that all receipts be accessible to the Plan Administrator. If you do not submit the required receipts to S & A, Inc. in a timely manner, your card is subject to deactivation. The only time you do not need to submit receipts is when you use the Benefit Card to pay for co-payments—doctors’ visits and prescription drug. Co-payments are automatically approved by the Benefit system; however, it is required that you keep your receipts on-hand in case of an audit. The Plan Administrator reserves the right to request receipts for any and all purchases, including co-payments.
  
• Your Benefit Card balance is automatically adjusted (real-time) to reflect your purchase.
  
• The Plan Administrator will verify that all Benefit Card transactions are eligible. If not, you will be notified and your card will be subject to deactivation.

Please contact S & A, Inc. with any questions regarding your plan or account.