Flexible Benefits Health Care Reimbursement Claim Form Instructions for Online Claim Filing Claims may be filed online at www.mgmflex.com.
Log into your account and enter your claim information under the “File Claims” section.
Attach copies of bills, receipts or other evidence of eligible out-of-pocket expenses for reimbursement.
Date Service Incurred Patient Name Provider Name Description of Service (e.g., RX, co-pay, dental, office visits, etc.) Amount Requested Total Requested MGM Benefits Group 2121 N.
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