Web Settings
Account Settings
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Enroll in Automatic Payment from Flexible Spending Account or Healthcare Reimbursement Account
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Activate Enrollment |
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Settings for plan year: 01/01/2006 - 12/31/2006
NOTE: Your enrollment will be effective today. It will not be backdated to the policy effective date.
By clicking Confirm Enrollment, I authorize UnitedHealthcare to make automatic
reimbursement payments from my health care Flexible Spending Account or Healthcare Reimbursement Account for expenses submitted to, but not payable by, my health care plan. I certify that expenses to be reimbursed automatically through my Flexible Spending Account or Healthcare Reimbursement Account will be incurred by me (and/or my
spouse and/or my eligible dependents) and will not be reimbursed by another plan. I/we will not use the expenses reimbursed through the Flexible Spending Account or Healthcare Reimbursement Account program as deductions or credits when filling out my/our individual income tax return.
I understand that any person who knowingly files a statement of claim containing any misrepresentation or any false, incomplete or misleading information may be guilty of a criminal act punishable under law and may be subject to civil penalties.
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