Payless provides this plan to eligible Associates to aid in the reimbursement for Qualified Adoption Expenses.

• All Full-time Associates who have completed at least 6 months of consecutive service are eligible.
  
  
• All requests for claims must be submitted no later than 6 months after the adoption is finalized. Complete the Adoption Assistance Reimbursement claim form.
  
  
• Maximum reimbursement amount per adopted child is $2,000.
  
  
• Only one Associate may apply for reimbursement of Qualified Adoption Expenses incurred in an adoption where two Associates adopt a child.
  
  
• IRS approved Qualified Adoption Expenses include:
  • Legal Expenses
  • Court Fees
  • Adoption agency fees, including foreign adoption fees
  • Pregnancy expenses for the birth mother if not covered by another source
  • Temporary fostercare expenses
  • Medical examination fees for the child, if required, and not covered by another source
  • Transportation fees to bring the child to the adopting parents
  • Transportation expenses for the adoption parents, including meals and lodging
    
    
• To process a request for reimbursement, the following documentation is required:
  • A certified copy of the adoption decree and birth certificate
  • Bills, invoices, receipts, cancelled checks or other statements showing the amounts and incurred date of the expenses
  • Additional documentation may be requested in order to substantiate expenses that are eligible for reimbursement under the IRS Guidelines.
  
  
• All requests should be submitted to the Corporate HR Benefits Department.
  
  
• Expenses for the adoption of a spouse's children (stepchildren) are not covered under the plan.

Note: If you wish your adopted child to be covered by your Payless benefit plans, you must enroll your dependent within 30 days of the date the adoption is finalized.