The following information was received from Paul Sugarman via e-mail overnight. I am re-posting here, along with the forms, for those who may not be on the e-mail list.
Wageworks Health Care Reimbursement Claim Form:
Wageworks Dependent Care Reimbursement Claim Form:
To Heller Ehrman Former Employees:
If you were a participant in the Firm’s Flexible Spending Account Plan, your participation automatically ended on the date your employment with the Firm ended. The rules are different for the deadlines that apply to the submission of requests for reimbursement of Dependent Care and Health Care expenses.
Health Care Reimbursement Claims: Health care expenses you incurred after your employment with the Firm ended will not be reimbursed, unless you elected to continue to make contributions to the Plan on an after-tax basis pursuant to the provisions of the Consolidated Omnibus Budget Reconciliation Act of 1985 (“COBRA”). This election opportunity was provided to you in the COBRA election packet you received from PayFlex. If you did not elect COBRA continuation coverage for your health care reimbursement account, reimbursable expenses are limited to those you incurred while employed by the Firm, and you must submit health care reimbursement account claims within 90-days of the date on which your employment ended or by March 31, 2009, whichever date is earlier. Thus, if you did not elect to participate in the Plan after you left the Firm’s employ and your last date of employment was October 15,2008, you must submit claims for reimbursement of health care expenses incurred on or before October 15, 2008 no later than 90 days after your last date of employment.
Dependent Care Reimbursement Claims: You must submit dependent care reimbursement account claims no later than March 31, 2009. You will only be reimbursed from your dependent care reimbursement account if you had a positive balance in the account when your employment terminated. You may also be reimbursed for eligible dependent care expenses you incurred during the remainder of the Plan Year in which your employment ended from amounts that you contributed prior to your termination of employment.
Please complete the attached forms to submit your claims and fax to WageWorks at 877-353-9236. If you have any questions, please contact Cheryl Vance at email@example.com.