The Medical Claim Form and the MRA and/or HCSA Claim Form are available on My Health. The forms are also available on the health care company's websites.

Please Note: You can elect to have your MRA reimbursement directly deposited into an account of your choice by accessing your health care company at My Health.

You need to file your Medical and MRA reimbursement claims by December 31 of the year after the one in which you received the service or purchased the prescription. For example, if you incur an expense on July 1, 2022, you must file your claim for reimbursement by December 31, 2023. If you fail to meet this deadline, your claim will be denied.

Be sure to attach itemized receipts to your claim form, and keep copies for your records.

You can submit an MRA/HCSA reimbursement request online or via the App (Cigna or PayFlex).

Mail your claim form to the address printed on the forms: