Home About Us Group Services Resource Links Carrier Links Aetna American Specialty Health Blue Cross of California Blue Shield of California California Choice Cigna Insurance Delta Dental Guardian Insurance Health Net Insurance Humana Kaiser Permanente PacifiCare Principal Insurance SafeGuard Sharp Health Standard Insurance The Hartford United Health Care VSP Useful Links Health A to Z RX List Social Security Online Flexible Benefit Plans Your Account Tax-Free Spending Accounts Types of Accounts Reimbursement Annual Loss of Unused Funds Termination of Employment Changing Your Contributions Frequently Asked Questions Individual Plans Web Site for Individuals Blue Cross of California Blue Shield of California Downloads Individual Forms Blue Cross Application HIPAA Authorization Form Blue Shield Application BS Transfer App / Non-Underwritten BS Transfer App / Underwritten BC Individual Change of Coverage App Templates Credible Coverage 2007 Contact Us General Information Group Insurance Individual Insurance Flexible Benefits
Nico Insurance Services Inc. 7290 Navajo Road, Suite 111 San Diego, CA 92119 CA License # 0790551 Ph:  (619) 667-2111   (800) 303-3737 Fax:  (619) 667-2100	Reimbursement Once you have money in your Spending Accounts, you can withdraw an amount from each account to pay yourself back for incurred expenses that are eligible for reimbursement from that account. Healthcare expenses cannot be reimbursed from the Dependent Care Account and dependent care expenses cannot be reimbursed from the Medical Care Account. Claims must be incurred during the plan year in order to be reimbursed. Required Documentation To be reimbursed - or paid back - with tax-free dollars, you must submit the following items: A completed reimbursement form Your receipts for expenses. Receipts for healthcare expenses must include: date of service, name of patient, name of doctor or provider of service, type of service performed and amount owed by you. Receipts for dependent care expenses must show: period covered, name and age of dependent, name of provider, federal tax I.D. or Social Security number of provider, and amount paid. Cancelled checks and credit card receipts are not acceptable receipts. For information or personal assistance, please contact the Benefits Department or our Flex Plan Administrators. If you have any questions regarding Flexible Benefit Plans, please contact Gale Seaman.