If you file a claim for an eligible expense that exceeds the available balance you have in one of your benefits, it will create a “Reimbursement Plan” to pay you back in installments until you get the full amount. Please note that a reimbursement plan will only be created if you see the below message display after entering the amount on the claim submission screen.
Once the claim is reviewed, you’ll first be reimbursed the available balance in your account, then Forma will pull from your available balance each month on the date of approval to pay toward this claim until the amount is paid off in full. If you do not have any funds at that time, $0 will be applied to the claim.
If the program year ends before you receive the full amount, depending on your company's policy, you might forfeit the rest of the claim. Check the program policy for more details about whether or not reimbursement plans roll over into the next program year.
You don’t need to do anything differently to set up the Reimbursement Plan, just file a single claim for the full purchase amount.
Example
Let’s say you get $100 on the first of each month in a Wellness benefit, and you currently have $100 available.
You purchase an eligible item that costs $800, and you file a claim for $800 that’s approved on January 14. You’ll first be reimbursed the entire available balance in your Wellness benefit.
Then, on February 1, you get your next Wellness deposit of $100. On February 14 (the day of the month the claim was approved), you’ll be reimbursed the entire balance in your Wellness benefit.
This process will keep going until the original $800 claim has been completely reimbursed.
What isn’t a reimbursement plan?
Reimbursement plans should not be used for recurring expenses such as a gym membership that renews on a monthly basis. Reimbursement plans can be used for annual gym memberships where the entire year is paid up front.
Claim status page, explained.