Example: dental hygienist
SHEET METAL WORKERS LOCAL UNION 30 WELFARE PLAN - …

SHEET METAL WORKERS LOCAL UNION 30 WELFARE PLAN - …

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HEALTH CARE SPENDING ACCOUNT CLAIM SUBMISSION FORM This form should be used when claiming reimbursement under your Health Care Spending Account for eligible expenses which are not covered (or not covered in full) by your Health or Dental Plan.

  Health, Form, Account, Claim, Spending, Spending account, Spending account claim

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