Submitting A Claim
Dependent Daycare FSA and Healthcare FSA and/or HRA claims not paid for with the Benesyst Benny™ Benefit Card can be filed anytime with Benesyst.
Online Claim Wizard
The fastest and easiest way to submit your claim is using the Online Claim Wizard. It allows you to submit your FSA and/or HRA expense information online and gives you the option of uploading your scanned documentation or printing a bar-coded cover sheet to fax your supporting documentation to Benesyst.
You can enter multiple expenses all in one claim, and you can save your work and return at any time!
You can upload supporting documentation online (documents should be in .JPG, .TIFF or PDF format and must be 8MB or smaller) and the system allows you to view and review your documents before submitting your claim.
If you do not upload documentation, you will be presented with a Fax Cover Sheet to print and fax along with your documentation to (800) 310-8279 after you submit your claim.
Toll Free Fax
If not using the
Online Claim Wizard, to be reimbursed for any eligible expenses (for both Healthcare and Dependent Care FSAs), you must mail or fax (not both) a completed Easy Reimbursement Request form along with IRS required documentation.
- Fax toll-free any time to: (800) 310-8279
- To expedite faxed claim processing – please submit copies of receipts on 8x11 paper. Do not highlight the expense on the receipt as this can block the fax transmission.
- If you have signed up for email alerts, you will receive email confirmation when your fax is received.
Claims in progress
The status of your faxed and online submitted claims will be available through the
Most Recent Faxed/Online Claims tracker on the Spending Account Services Dashboard via logging into your online account.
Login here
Healthcare Claim Form
You can submit claims using the Online Claim Wizard, or download and print a new form for each claim (due to the design of the form, do not photocopy).
Dependent Daycare Claim Form
You can submit claims using the Online Claim Wizard, or download and print a new form for each claim (due to the design of the form, do not photocopy).