You must submit a HEALTH IMPROVEMENT BENEFIT FORM and a itemized receipt to the Teachers Health Trust within twelve months of receipt date. The form will require the following information:

• Your identification and/or social security number
• Your name and address
• Your telephone number
• Your date of birth
• Services which reimbursement is requested
• Amount paid for services

• Medication and Supplements
• Any form of equipment
• Books, magazines, and/or journals
• Videos, CDs, DVDs, and any other electrical educational device
• Entry fees for charitable events
• Expenses related to seminars

Hand written or non-itemized receipts will not be accepted and will not be eligible for reimbursement under this benefit.