STEPS FOR a SUCCESSFUL CLAIM reimbursement submission

These are the steps to follow so each claim you submit has all of the necessary components and supporting documentation for successful reimbursement payout. Please review your entire Reimbursement Instructional Guide for additional information. If you have misplaced the guide that was previously mailed to you, please contact a Benefits Counselor to request a new copy.

Step 1

You pay for your eligible insurance premiums or health expenses
You will arrange the method and frequency of premium payments directly with your insurance company.

You will pay all out-of-pocket expenses, such as copays, to your health care provider.

For all eligible expenses, save all receipts and supporting documentation to include with your reimbursement claim.
Step 2

You determine how you want to receive your reimbursements

Direct Deposit: You may enroll in direct deposit online by visiting the subsidy portal or by completing the Direct Deposit Form. Direct Deposit is more convenient as your reimbursements will be sent directly to your designated banking account. (Note that direct deposit may take up to 30 days to activate, which means your first reimbursement after enrolling in direct deposit may be mailed in the form of a check.)

Physical Check: If you do not enroll in direct deposit, you will receive a mailed physical check to the address we have on file.
Step 3

You request reimbursement from your subsidy account

Automatic Premium Reimbursement: This reimbursement option is available if you have enrolled in a qualifying health plan through Mercer Marketplace 365. No form or additional documentation is required by you. Please visit your subsidy portal to see a list of participating carriers and plans as well as to opt-in to Automatic Premium Reimbursement. Refer to your Reimbursement Instructional Guide for additional requirements and details on this option.

OR

Recurring Premium Reimbursement: This reimbursement option is available if you have enrolled in a qualifying health plan through Mercer Marketplace 365. You will only submit one Recurring Premium Request Form each calendar year, or each time your premium rate changes. All Recurring Premium Reimbursement claims require third-party documentation showing proof of expense and coverage and must include: covered participant's name, premium type and proof of coverage. More details about expected reimbursement dates can be found online in your subsidy portal under "Important Information". Refer to your Reimbursement Instructional Guide for additional requirements and details on this option.

OR

One-Time Reimbursement: This reimbursement option is available for any eligible expense.. You will need to provide a completed One-Time Reimbursement Claim Form , proof of premium/eligible expense, and proof of payment of premium/eligible expense each time you submit an eligible expense. More details about expected reimbursement dates can be found online in your subsidy portal under "Important Information". Refer to your Reimbursement Instructional Guide for additional details on this option.
Step 4

Mercer reviews your claims and, if approved, reimburses you from your available subsidy account balance

Once your request has been received, Mercer will review your legally required supporting documentation and determine if the claim is in good order. If approved, you will receive payment by either direct deposit or a check in the mail depending on how you elected to receive your reimbursements. Refer to your Reimbursement Instructional Guide for additional information.