ADOPTION REIMBURSEMENT
Request for Adoption Expense Reimbursement form
• The maximum reimbursement per adoption transaction per employee, per calendar year is $5,000.
• This benefit is pro-rated for employees working less than full time.
• Reimbursement requests may include services received within the current calendar year or during the prior calendar year.
• If more than one child is adopted during a single adoption transaction, the maximum reimbursement is $5,000 for the calendar year.
• Employee must request reimbursement using the Request for Adoption Expense Reimbursement form and provide appropriate supplementary documentation (e.g. must include both invoices and corresponding proof of payment).
• Reimbursement is made in the employee's paycheck and can be paid in either a $5,000 lump sum or in smaller amounts as expenses are incurred
• Submit a completed Request for Adoption Expense Reimbursement form and appropriate supplementary documentation (e.g. must include both invoices and corresponding proof of payment)
• All Adoption Requests (with supporting documentation) must be received no later than November 1st to guarantee reimbursement within the calendar year.
• Send documents to the Benefits Office via email (scan), fax or mail
Email: Benefits.Human.Resources@Dartmouth.edu
Fax: (603) 646-1108
Mail: Health Benefits, Human Resources- Benefits Office (HB 6042) 7 Lebanon Street, Suite 203 Hanover, NH 03766
• Keep copies of all documents for your files.
• Materials will be reviewed. Provided that all documentation is accurate, once the request has been approved, the Benefits Office will send a confirmation email to the employee about expected reimbursement amount and timeline.
• Incorrect or incomplete requests will cause delay in review and reimbursement.
• Reimbursement will appear in the employee's paycheck under the following line item (Adopt Reimb.)
A Health Benefits Administrator, is available to advise supervisors and employees on all aspects of the adoption reimbursement process. Please contact the Human Resources Benefits office at (603) 646-3588 and ask to speak to a Health Benefits Administrator today.
