You can download and print the claim forms needed to request reimbursement from your Health Care and Dependent Spending Accounts via My Health or on your carrier's website (Aetna/PayFlex or Cigna).

Please Note: The Dependent Care Spending Account requires that your receipt include the care provider's name, address and taxpayer identification number (or Social Security number). Without this information, the care usually won't qualify as an eligible Dependent Care Spending Account expense.

Send your completed claim form and supporting receipts to the appropriate address or fax number:

You must submit claims incurred during the plan year (January 1 – December 31) by the claim filing deadline, March 31 of the year following the plan year. If you are submitting your claim by mail, the postmark date must be no later than March 31.