When entering a claim, please follow the steps and instructions below,
Important: In order to avoid the most common issues with FSA, HRA or Dependent Care claims, check your documentation to ensure that it includes the required elements.
The IRS requires that documentation shows: Date of service, Description of service or item, Recipient of service, Service Provider, and Amount. Some HRA’s require submission of an Explanation of Benefits (EOB) , please review your plan documents to see if this applies to your plan.
To submit a claim for eligible expenses to your FSA, HRA or Dependent Care account, log into your account to enter the claim and submit required documentation.
Here’s how to submit a claim.
Log into your account and select the account on the home page.
Click Reimburse Me if you would like to be reimbursed for expenses already paid out of pocket or Click Pay Provider if you would like us to send a payment directly to your Provider.
Enter payment information and select Submit Claim
Upload the digital copies of documentation. If you are submitting a claim against your HSA, documentation is not required.
Note: You won’t be able to cancel or delete a claim once it has been submitted for reimbursement in your account. If an error is made in a submission, you'll need to submit a new claim with the correct information and documentation.
Documentation Requirements
The IRS has very specific rules for FSAs, HRAs and Dependent Care account and all expenses must be verified with the appropriate documentation. Note: HSAs do not require documentation in order to submit a claim.
In order to ensure timely processing of your claim, please ensure that your documentation includes the required elements:
Recipient of Service. The name of the person who received the service or for whom the item was purchased. For retail store purchases, this information may be excluded. For a medical claim this would be the patient who received the services and for a Dependent Care claim this would be the name of the dependent who received care.
Service Provider’s Name and address. The provider that delivered the service or the merchant where the item was purchased.
Date of service. The date(s) when services were provided or the item was purchased.
Description of Service or Item: A detailed description of the service provided, or item purchased. A bag tag is sufficient for prescriptions.
Amount. The amount paid for the service or product and/or portion that is not reimbursed through your insurance carrier.
Documentation Requirements for reimbursement of premiums
Check your plan documents to see if premiums are eligible under your plan, and what specific types are covered.
If your plan allows reimbursement for medical premiums, you mut show proof of coverage and proof of payment. Generally, the proof of payment must be post tax.
Examples of acceptable documentation for premiums include:
Medicare Premiums
The Social Security Statement ( SSA) , COLA or a Pension Statements are the best pieces of documentation to submit. Also acceptable are Retirement statements or State Annuity statement.
Proof of payment if not an SSA, Annuity Statement or COLA statement can be
Paycheck stub; ensure it shows post tax
The back of the canceled check or a bank statement.
Insurance Premiums
Submit provider policies, benefit letters, or statement and bills for proof of coverage.
Proof of payment can be paycheck stub (ensure it shows post tax), the back of the canceled check or a bank statement.
Do’s and Don’ts for submitting documentation
Do’s
Do use your Explanation of Benefits (EOB), especially if your insurance paid a portion of the expense. Some HRAs require EOB submission, please review your plan documents to see if this applies to your plan.
Do make sure your receipt is legible; check that it isn’t too dark or light and that information is not cut off.
Do include stamped provider information on handwritten receipts.
Don’ts
Don’t send credit card receipts, cancelled check or provider statements that say Balance Forward, but do not include the services that were provided. These typically do not include all five key pieces of information.
Don’t use highlighters on your receipts.
Editing a claim
You won’t be able to edit or delete a claim once it has been submitted for reimbursement in your account. If an error is made in a submission, you'll need to submit a new claim with the correct information and documentation.