Submit Reimbursement Requests for eligible medical, dental and vision care expenses that will not be reimbursed by any other employer-sponsored benefit plan and which would qualify as a deduction on your income tax form.

Submit Reimbursement Requests for eligible day care/child care expenses that will not be reimbursed by any other employer-sponsored benefit plan and which would qualify as a credit on your income tax form.

Expenses must be incurred within your eligible timeframe of your company’s sponsored FSA Plan Year.

In order to guarantee that your request is processed, your reimbursement request MUST be received four (4) business days prior to your company’s scheduled processing date. Requests that are received after this time may remain pending until the next scheduled processing date. Please refer to your Flexible Benefit Plan Highlights for your company’s processing cycle. Please see the timeline below for an estimate of the time required for auditing and entry of your request into IAS systems. Please note that holiday closure WILL change the timeline indicated below by increasing the amount of time required for your request to be audited and entered into our system to await your company’s scheduled processing date. Requests submitted over the weekend are considered received on Monday or the next business day in the event of a holiday.

Request is submitted prior to 5:00 PST on one of the following business days	Monday	Tuesday	Wednesday	Thursday	Friday
Request is ready for processing and viewable online for verification	Friday	Monday	Tuesday	Wednesday	Thursday

• Complete ALL applicable sections of the Reimbursement Request Form.
• Submit with this form proof of your expenses: an itemized bill from your medical care provider, an explanation of benefits from your insurer, or a statement of service from your dependent care/child care provider or similar receipt.
• Proof of expense must show: date of service, description of service or expense, name of doctor or provider of service, prescription name and amount of expense.
• Submit your reimbursement request and proof of expenses using one of the following methods:
  • Log on to your secure flex account, select the "Upload Forms" option and attach your scanned reimbursement request and all substantiating information. Please note that this is the only option that protects your personal information.
  • Attach your Request and all substantiating information to an email and send it to flex@goigoe.com
  • Fax your request and all substantiating information to 858-777-5424; 888-357-6307
  • Mail your request and all substantiating information to: Igoe Administrative Services, P.O. Box 501480, San Diego, CA 92150-1480

• Reimbursement requests can be made at any time within your company’s plan year. Please verify this information by referring to your Flexible Benefit Plan Highlights or by contacting your company’s Benefits Department.
• Reimbursements are not assignable and can only be payable to you, the participant – not a relative, spouse or provider.