Participant Help
What information should I send when I'm submitting a claim?
You should include:
For Medical Claims
- Complete the Medical Spending Account portion of the Request for Reimbursement form in its entirety, the form must be signed and dated.
- An itemized bill/receipt that includes date of service, name and address of the provider, a description of the service and amount charged. An Explanation of Benefits (EOB) from your Insurance Company is the best documentation.
For Dependent Claims
- Complete the Dependent Care Spending Account portion of the Request for Reimbursement form in its entirety. Include the amount paid and date(s) of service.
- You must include your provider's signature, name and Social Security Number or Tax Identification Number. If you do not have your provider's signature, a receipt must be attached.
For more detailed information on claims submission, please download the Request for Reimbursement form.
View additional questions:
- Submitting and Processing Claims
Please Note: Claims must be submitted to HFS by 12:00 p.m. the day prior to your groups scheduled processing date.- How can I submit claims to HFS?
- What information should I send when I'm submitting a claim?
- How do I know my fax was received by HFS?
- When will I receive my reimbursement check?
- Logging into your Account
- Miscellaneous FAQs