Flexible Spending Claim Filing Process How to get reimbursed for your Health or Dependent Care expenses

Enrollment Decide on your plan year election and enroll in the program Decide on your plan year election and enroll in the program Money will be deducted from your paycheck on a pre-tax basis in equal increments every pay period and placed into your Reimbursement Account where your pre-tax money will accumulate until you file a claim for reimbursement. Money will be deducted from your paycheck on a pre-tax basis in equal increments every pay period and placed into your Reimbursement Account where your pre-tax money will accumulate until you file a claim for reimbursement.

Register on our Website Once you are enroll in the program, TLC will send you a confirmation letter with website instructions to your home address Once you are enroll in the program, TLC will send you a confirmation letter with website instructions to your home address Please take a moment to register on our website, The website is where you will be able to obtain a Claim Form, fill out an Online Claim Entry or view your account balance and payments made Please take a moment to register on our website, The website is where you will be able to obtain a Claim Form, fill out an Online Claim Entry or view your account balance and payments made

File a Claim for Reimbursement File a Claim for Reimbursement Once you have incurred an expense, you are eligible to file a claim for reimbursement The expenses must be incurred while you are a participant in the plan Once you have incurred an expense, you are eligible to file a claim for reimbursement The expenses must be incurred while you are a participant in the plan Log-in to Print a claim form under your documents folder or use our online claims entry service (documentation of expenses still required) Log-in to Print a claim form under your documents folder or use our online claims entry service (documentation of expenses still required)

Online Claims Entry Service

Submit Documentation Once you have completed a Claim Form or created one using the Online Claims Entry Service, please print the Claim Form, sign and fax, mail or the form with your supporting documentation to TLC Administrators Once you have completed a Claim Form or created one using the Online Claims Entry Service, please print the Claim Form, sign and fax, mail or the form with your supporting documentation to TLC Administrators TLC will verify the expenses are eligible and process your reimbursement TLC will verify the expenses are eligible and process your reimbursement

Reimbursement Reimbursements are processed each pay period following the submission of a claim Reimbursements are processed each pay period following the submission of a claim We highly encourage you fill out and return a Direct Deposit form to TLC Administrators so that we can directly deposit the funds into your bank account We highly encourage you fill out and return a Direct Deposit form to TLC Administrators so that we can directly deposit the funds into your bank account

Customer Service Contact Information For general information or to view your account balance and payments made, feel free to log-in to our website at any time. Please contact us for website instructions, questions or concerns For general information or to view your account balance and payments made, feel free to log-in to our website at any time. Please contact us for website instructions, questions or concerns Flexible Spending Department Flexible Spending Department (800) x 606

Reimbursement Flow Chart Blue = Action Required for Participant Yellow = Action Required for TLC Administrators Blue = Action Required for Participant Yellow = Action Required for TLC Administrators Participant Enrolls in Program TLC Sends Welcome Letter Participant Registers on Website Participant Incurs Expense Participant Logs into Website to Obtain Direct Deposit and Claim Form TLC Verifies Eligibility and Processes Reimbursement Participant Returns Direct Deposit Form Participant Sends Claim Form with Documentation to TLC