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How do I get the Adoption Assistance Program Reimbursement Form?
Click here. You can also get the form by calling myHR at 1-713-496-7600.
Will taxes be taken out of the reimbursement?
It depends. No federal taxes will be taken out of the reimbursement, but state and local taxes may apply.
Where do I send my completed form?
Submit your form—along with scanned bills or receipts—to myHR@Hess.com. Alternatively, you can mail this form and copies of your bills or receipts to:
Adoption Assistance Program
Hess Corporation
1501 McKinney Street
Houston, TX 77010
Attn: myHR Team
How do I get reimbursed?
When the adoption is finalized, complete the Adoption Assistance Program Expense Reimbursement Request Form and submit it to:
WINFertility, Inc.
Greenwich American Center
One American Lane, Terrace Level
Greenwich, CT 06831
Attn: WINFertilitySpecialty Services
Or email to: WINSpecialtyServices@Win-Healthcare.com
Along with the form, you’ll need to submit copies of bills or receipts that substantiate the nature and amount of each expense incurred. For more information, see the Adoption Assistance Program Overview.
If I leave Hess, do I have to return reimbursements I’ve already received?
No. Any reimbursements you received prior to leaving Hess are yours to keep.
What happens if I leave Hess before I am reimbursed?
If you leave Hess, any eligible expenses incurred but not reimbursed prior to your last day at work are not eligible for reimbursement.
Must I be employed by Hess to be reimbursed?
Yes. To be eligible for reimbursement, expenses must have been incurred and the adoption must be finalized while you are employed by Hess.
What expenses are eligible for reimbursement?
Necessary and reasonable expenses for the primary purpose of adoption are eligible for reimbursement through the program. These include:
- Application fees
- Home suitability studies
- Agency and placement fees
- Legal fees and court costs
- Immigration, immunization and translation fees
- Parent, child and family adoption counseling
How much can I receive?
You can receive up to $15,000 per adoption, tax-free for up to two successful adoptions.
Any expenses reimbursed in an unsuccessful adoption before a successful adoption count toward the $15,000 reimbursement limit. The limit is reset after a successful adoption.