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FSA Reimbursement Statement
- To: Robert (TELL_ME)
- Subject: FSA Reimbursement Statement
- From: Premera [http://www.Premera.com/~Macrosoft]
- Date: Sun, 20 Jan 2008 01:40:33 -0800
- Sent: Tuesday, January 15, 2008 4:09 AM
Categories: HR
The purpose of this email is to notify you of your Flexible Spending Account
Reimbursement.
The reimbursement was made to:
ROBERT
where-I-live
Macrosoft Flexible Spending Account
Reimbursement Date: 01/15/2008
Deposit No: 0006396296
Employee Id: 360959
Company Name: Macrosoft Corporation
Claim Date Claim Description Submitted Excluded Exclusion Description
Paid
002-01 01/08/2008 ROBERT -M 102.25 102.25
Total Paid 102.25
- You can access additional Flexible Spending Account detail (including
account balance and reimbursement information) online via MacrosoftHealth at
http://hrweb/macrosofthealth. If you have already registered, you can also
access MacrosoftHealth from outside the corporate network at
http://www.macrosofthealth.com.
- If your claim for benefits has been denied, in whole or in part, you may
appeal the denial. You must appeal within 180 days of the date you receive the
denial. Your appeal must be in writing and must provide additional material or
information which establishes that the expense is eligibile and covered. Your
appeal should be sent to the FSA Claims Center. In connection with your appeal
you may also review pertinent documents (such as your employer's plan
documents) and submit written issues or comments.
FSA Claims Center
box 534134
St. Petersburg, FL 33247-4134