Participants

Substantiation is key to success with your FSA.

Medical Flexible Spending Account (FSA)

For medical expenses, the IRS requires:

  • Date service was received or purchase made
  • Description of service or item purchased
  • Dollar amount
  • Provider or store name
  • Prescription drug number and name

Helpful hint for a smoother reimbursement from your Health FSA:

  • In some cases, the Plan’s design requires that your health insurer’s explanation of benefits (EOB) is provided as substantiation for your expense.
  • If you receive a receipt from your provider for a copay amount, make sure the receipt says “copay.” If not, ask your provider to write “copay” on your receipt before leaving the office.
  • Vague or missing information causes your reimbursements to be held up or become ineligible, so hang on to your receipts and documentation.

Dependent Care Accounts (DCA)

For dependent care expenses, the IRS requires:

  • Dates of service
  • Dollar amount incurred
  • Day care provider name
  • Day care provider Tax ID or Social Security Number
  • Day care provider signature

Helpful hint for a smoother reimbursement from your DCA:

  • Day care expenses must be incurred (not just paid) in order to receive reimbursement. If you prepay day care, please submit only as incurred. Registration fees cannot be reimbursed until the services are actually incurred.
  • Report your dependent care provider’s Tax ID (TIN) or SSN on IRS Form 2441 when you file your federal income tax return.
  • Vague or missing information causes your reimbursements to be held up or become ineligible. Hang on to your receipts and documentation.

View Reimbursement Options »

How to Submit 

Online

  • Enter claim information online.
  • Print confirmation and fax along with your proof of purchase.
  • Reimbursement will be processed once your substantiation is received.

Fax

Mail


Choose your reimbursement method

For customer service
or to send documents: