How do I get a reimbursement request form?

You received a reimbursement request form in your original enrollment packet.  We recommend that you make a few copies for future use.  Once you submit a reimbursement request, a new reimbursement form will be sent to you with your reimbursement check.  If you need additional reimbursement forms, or should you lose your reimbursement form, simply CLICK HERE or call Benefit Express at 1.877.837.5017.
Last Modified: 3/4/2011

How do I fill out a reimbursement request form?

Above, you can see our Reimbursement Form example in PDF format.  You can also see Sending Claims.  These examples will enable you to correctly complete your reimbursement form.   Please call us, toll free, at 1.877.837.5017 if you need further assistance.
Last Modified: 3/4/2011

How do I submit my reimbursement request?

• Fax your reimbursement form along with proof of service to 1.253.793.3766.
• Mail your reimbursement form along with proof of service to:
  Benefit Express
  P.O. Box 189
  Arlington Heights, IL    60006-0189
• Scan and email your reimbursement form along with proof of service to help@mybenefitexpress.com

If I submit a reimbursement form, when will I get my reimbursement check?

You need to have your reimbursement form to us by close of business Tuesday or Wednesday depending on your employer.  Please refer to the confirmation packet you received after you signed up for the FSA program for your claims deadline.

• Checks are mailed on Friday.  Direct deposit reimbursements are sent to the bank on Friday and will post to your bank account the following Monday or Tuesday depending on your bank.  
• Medical account claims will be paid up to annual election amounts.
• Dependent account claims will be paid up to corresponding account balance.
• Processing schedules will be adjusted to accommodate holidays.

Is there a deadline or cutoff time for reimbursement request forms?

The cutoff time is 5:00 p.m. Central Time Tuesday or Wednesday depending on your employer.  This timing may be somewhat different when a holiday is involved.

It is important to remember a few things.

• All required documentation must be received with your reimbursement form in order for the reimbursement to be paid. 
• If you are sending your reimbursement form in by fax, you should send it no later than 4:30 p.m. the day of the deadline to allow for minor transmittal delays that occur when using the fax.
• Third, your reimbursement request must be for eligible expenses.

What type of documentation is required to process my reimbursement?

You must submit Proof of Payment with each reimbursement form that you submit.

What is Proof of Payment?

Proof of Payment would be a copy of your statement, visit record, Explanation of Benefits (often referred to as an EOB), or similar document.  In other words, a document that clearly shows what you have already paid.  The document must include the date the service was provided, description of the service provided, the name of the person receiving the service and the amount of payment.  Balance forward statements, cancelled checks or credit card receipts are not considered as valid proof of payment.  Incomplete or unreadable forms and receipts will delay the reimbursement process.
Last Modified: 11/24/2009

What do I do if I don’t have an Explanation of Benefits (EOB) or the expense for a service is not covered by any of my benefit plans? How do I provide proof of a claim for my Health Care Spending Account?

An Explanation of Benefits (EOB) is not required for filing a reimbursement request.  The advantage of an EOB is that it certainly minimizes any potential questions regarding your request for reimbursement.  It also reduces delays in processing your reimbursement request.  Remember, if you do not have an EOB, you must submit an itemized receipt or bill that reflects the type of service, the date of service, the name of the person receiving the service and the amount of the payment that is your responsibility.

Why can't my credit card or balance due receipt be used as an appropriate receipt?

The IRS has determined that credit card receipt statements, carbon copies of checks, canceled checks, or balance due statements do not provide enough required information.  In order to properly process your claim you must submit an itemized receipt or bill that reflects the type of service, the date of service, the name of the member receiving the service and the amount of the payment that is your responsibility.

Why was my reimbursement request denied? Or why wasn’t my reimbursement request paid?

There are several possible reasons why your reimbursement request was not paid:

Your reimbursement form may have been received too late.  Reimbursement forms must be received by Wednesday at 5:00PM CST in order to be processed by the Friday of the same week.  If your reimbursement form was received after the deadline on Wednesday, it will be processed the following week.

Sometimes if you fax your reimbursement form to us there is a time delay from the time that you fax it and when we actually receive it.  That is why it is important to allow a little extra time when submitting your reimbursement form by fax.  We recommend that you fax your reimbursement form to us by 4:30PM CST on Wednesday to be sure that we receive it ahead of the deadline.

The reimbursement request that you submitted for dependent daycare expenses may have exceeded your current account balance.  In this case, your reimbursement form will be paid once more money is deposited to your account.

Your reimbursement request may be for ineligible expenses.  You should review the denial letter that you receive.  If you still have questions, you can call Benefit Express, toll free, at 1.877.837.5017.

Remember that the Internal Revenue Service determines exactly what expenses are eligible for reimbursement under a flexible spending account.   For a list of eligible expenses CLICK HERE.