State retirees entitled to a subsidy will receive that subsidy via a health reimbursement arrangement (HRA) administered by Via Benefits. Welcome to Via Benefits. Account Holder Signature Date Verify account holder information Complete reimbursement form Prepare supporting documentation Read Certification Medicare Part B premiums must be submitted each month with the use of this form. Via Benefits offers Medicare supplement plans (Medigap), Medicare Advantage plans, Part D prescription drug plans, and dental and vision plans. Simply fill out a Via Benefits Reimbursement Request Form, attach backup documentation, and mail or fax it to Via Benefits. Employer contributions to the insurance plan may be paid directly to the provider or they may reimburse the employee for … your Social Security Benefit Payment, please include a copy of the Benefit Award/Proof of Income Letter issued by the Social Security Administration. Upon receiving notice of a change in premium or a cancellation of coverage, I will notify Via Benefits within a suitable time period. Reimbursement forms are available through the retiree's Via Benefits online account (link opens in new window) and by phone at 1-844-287-9945. An Explanation of Benefits (EOB) from your health insurance … Now, creating a Via Benefits Forms takes at most 5 minutes. Our state browser-based blanks and clear guidelines eliminate human-prone faults. 3. We apologize that our site is not fully accessible to customers using screen readers at this time. Comply with our simple steps to get your Via Benefits Forms well prepared rapidly: Select the web sample … When employer and employee have both contributed, but the employer’s contribution isn’t included in the employee’s income, only part of the excess reimbursement is considered to be taxable. However, with our preconfigured online templates, everything gets simpler. You may call Social Security Administration to request a new Benefit Award/Proof of … Despite this, the security of the transmission of information via the Internet cannot always be guaranteed and you acknowledge this in your access and use of our … Helping millions of people, one at a time, to optimize today's health and wealth opportunities for a better tomorrow. We believe the name Via Benefits is a door opener and sets the stage much more effectively for clients to appreciate the full scope of our offerings and the value of our approach. All of the Exchange Solutions lines of business will now be marketed under the Via Benefits … Sign In Help. Via Benefits approves your request and provides reimbursement Via Benefits will process your reimbursement request through any method submitted, and once approved, reimburse you from your available funds. Via Benefits – Health Reimbursement Arrangement (HRA) Eligible retirees enrolled in a medical plan through Via Benefits (formerly Towers Watson’s OneExchange), and retirees enrolled in TRICARE for Life and Medicare Parts A and B, receive a monthly Years of Service contribution to a Health Reimbursement Arrangement … 9. We are currently building a new site with accessibility … You may receive your reimbursement by direct deposit or check, along with your Via Benefits … Each form includes a personalized barcode specific to the retiree's HRA as well as a check list detailing the required documentation needed with each claim type. What solutions are included in the Via Benefits solution suite? Working with us will help you make informed and confident enrollment decisions. The retiree MUST purchase a … Backup documentation is a receipt for payment from your doctor or pharmacist that must include the following informa-tion—Name of the provider, description of the service Out of Pocket Reimbursement Documentation: To file a request for an out of pocket expense (e.g., copay, deductible, coinsurance), you must provide proper supporting documentation from a third party (e.g., hospital, doctor, pharmacy) to qualify for the reimbursement. will not be submitted for future reimbursement. Via Benefits helps you choose the Medicare plan that best fits your medical needs and budget. Will notify Via Benefits helps you choose the Medicare plan that best fits your medical needs budget. Must purchase a … Welcome to Via Benefits of business will now be marketed the. Make informed and confident enrollment decisions at most 5 minutes of a change premium! Time, to optimize today 's health and wealth opportunities for a better tomorrow B! 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