How to write your Wellness Reimbursement Request
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How do you write a Wellness Reimbursement Request document?
Wellness Reimbursement Request Date: Current Date. Employee: First Last Department: Department Supervisor: Supervisor. Employee Job Information Position: Contract Job Title Status: Full-time Y/N Date of Hire: Work Type: Hourly ? Salary ? Shift Type: Day ? Night ? Swing ? Other ? Supervisor must complete the following form and file it with the Human Resources Department.
Employee must provide receipt(s) for all reimbursed wellness activities. Description of Wellness Program or Activities Describe the wellness program or activities you are seeking reimbursement for. Qualifications Does employee have receipt(s) of payment for the activities being submitted for reimbursement? Yes ? No ? Are the activities submitted for reimbursement "Qualified Wellness Program" activities? Yes ? No ?
Qualified Wellness Program Activities
Purpose of Company Name Wellness Reimbursement Plan:
The purpose of this plan is to provide our full-time employees with financial incentives and assistance to encourage participation in health and wellness activities and programs, such as health club memberships, aerobic / exercise classes, health education classes, and smoking and tobacco cessation or weight management programs.
Who can participate in Wellness Reimbursement:
Full-time, regular employees are eligible to participate in the wellness reimbursement program. The maximum benefit an employee can receive is limited to Insert $ Amount/month for all qualified activities. For an activity to be considered "qualified," the employee must participate in the activity for three consecutive months to be eligible for reimbursement. The company will also reimburse any previously paid qualified wellness expense so long as it is within six months of the reimbursement request, subject to documentation requirements.
The following activities shall be excluded from the Wellness Reimbursement plan:
Recreational sports programs (unless included in health club membership dues). Recreational sports events (including marathons, triathlons, tournaments). Personal trainer fees and personal fitness or sports equipment. Classes, training, or instruction that is not provided by a licensed business or instructor (proof may be required).
Meals, supplements, or aids for weight loss, body building, or for smoking / tobacco cessation. Massage programs. Medical treatment programs or therapy. Psychological treatment programs or therapy.
Fees, finance charges, late fees or other charges not a part of regular health club or classroom dues.
Payment Requirements:
All reimbursement requests must have a paid receipt showing the wellness activity purchased, date of purchase, the business Tax ID, and the period of time that the purchase covers. For multi-month purchases made up front, company shall reimburse up to Insert $ Amount/month, paid on a quarterly basis. Company will reimburse only wellness expenses incurred during employment with Company Name.
Expenses prior to employment with Company Name shall not be considered. Company reserves the right to request additional information or documentation on all requested reimbursements. Company may also deny a reimbursement expense if that expense is determined to be covered under an applicable health insurance plan or other reimbursable program.
Employees may not submit a wellness reimbursement request for any expense that has already been submitted or paid out through a Flexible Spending Account (FSA), Health Savings Account (HSA), or Medical Reimbursement Account (MRA). If you have any questions concerning the eligibility of any wellness expense, please consult the Human Resources Department.
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Frequently Asked Questions
How do I customize this contract to fit my business needs?
Customizing this contract involves editing the document to include your business details, terms, and conditions. The templates are designed to be flexible, allowing you to insert your company's name, address, and other relevant information. You can modify clauses to reflect your unique business practices and legal requirements.
Is this contract compliant with laws and regulations?
The legal contract templates are written by legal professionals and designed to comply with current laws and regulations at the time of their writing. However, laws can vary by jurisdiction and change over time, so it's recommended to have your contract reviewed by a local attorney to ensure it meets all legal requirements specific to your region and industry. Templates are licensed as self-help information and not as legal advice.
Can I use the same contract for different clients or projects?
You can use the same contract for different clients or projects. The templates are versatile and easily adapted for various scenarios. You will need to update specific details such as client names, project descriptions, and any unique terms for each new agreement to ensure that each contract accurately reflects the particulars of the individual client or project.
What should I do if I encounter a clause or term I don't understand?
If you encounter a clause or term in the contract that you need help understanding, you can refer to guidance notes explaining each section's purpose and use. For more complex or unclear terms, it's advisable to consult with a legal professional who can explain the clause and help you determine if any modifications are necessary to suit your specific needs.
How do I ensure that the contract is legally binding and enforceable?
To ensure that the contract is legally binding and enforceable, follow these steps:
- Complete all relevant sections: Make sure all blanks are filled in with accurate information.
- Include all necessary terms and conditions: Ensure that all essential elements, such as payment terms, deliverables, timelines, and responsibilities, are clearly defined.
- Signatures: Both parties must sign the contract, and it is often recommended that the contract be witnessed or notarized, depending on the legal requirements in your jurisdiction.
- Consult a legal professional: Before finalizing the contract, have it reviewed by an attorney to ensure it complies with applicable laws and protects your interests.
By Ian Lauder
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Proposal Kit, Inc. makes no warranty and accepts no responsibility for the suitability of any materials to the licensee's business. Proposal Kit, Inc. assumes no responsibility or liability for errors or inaccuracies. Licensee accepts all responsibility for the results obtained. The information included is not legal advice. Names in use cases have been fictionalized. Your use of the contract template and any purchased packages constitutes acceptance and understanding of these disclaimers and terms and conditions.