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Submitting Reimbursement Request Forms
Complete your Request Form using the online interactive forms.
Interactive forms allow you to enter information on the form using your computer instead of by hand. Tab and/or use your mouse to complete the form and automatically total the dollars you are requesting for reimbursement. Once you have completed the form, please make sure to print and sign your request form prior to submitting it for reimbursement. Please note that if any portion of your request form is incomplete, your request cannot be paid.
Gather your documentation to be used as back-up for your requested items / services.

Requirements for Medical Care documentation
  • Date service(s) incurred (e.g. the date the prescription was filled, the date a medical procedure was performed. The date an orthodontia adjustment was performed, etc. This is not necessarily the date that the service was paid for.)
  • Name of doctor or provider of service(s) (e.g. the name of the doctor who performed the medical procedure, the store from where the prescription or over-the-counter item was purchased).
  • Description of expense(s). A list of eligible expenses is available by clicking here.
  • Net dollar amount of each service or item

Requirements for Dependent Care documentation:
  • Period covered (timeframe for which you are requesting reimbursement)
  • Name of provider (the name of the person or facility that provides daycare for your eligible dependent)
  • Social Security Number or Tax ID of provider
  • Name and age of dependent(s)
  • Net dollar amount
  • The total dollar amount being requested for reimbursement

Requirements for Insurance Premium documentation:
  • Period covered (timeframe for which you are requesting reimbursement)
  • Name of provider
  • Net dollar amount
Scan your signed reimbursement request form and all receipts onto your computer & transmit your form to Igoe via one of the following.
  • Log on to your account at and securely upload your request form and all documentation.
  • Attach your file containing your request and all substantiating information to an email to [email protected]
While electronic transmission of your request is preferred, you may fax your completed request form and all substantiating documentation to (858) 430-5825 or mail your completed request form and all substantiating documentation to PO Box 501480, San Diego, CA 92150-1480.
Verify your request has been received and approved for payment.
Log in to your online account to verify receipt and approval of your request. Your request status will be available no later than four business days following the date that your request was received by Igoe.
Determine when and how your reimbursement will be received.
Reimbursement processing for your group will occur on a pre-determined schedule. Your reimbursement processing schedule is included in your enrollment materials. Your request for reimbursement must be received 4 business days prior to processing. Please see the timeline below for an estimate of the time required for auditing and entry of your request into Igoe systems.
Request is submitted prior to 5:00 PST on one of the following business days MondayTuesdayWednesdayThursday Friday
Request is ready for processing and viewable online for verification FridayMondayTuesdayWednesday Thursday