Claim Forms

To submit one of the following claim forms electronically or by mail, go to Submit Claims .

To submit a claim electronically, login and go to Submit Claims page.

FSA, HRA, and HSA Reimbursement Forms

General Forms

Membership & Enrollment Forms

Reimbursement Forms

Form 1095-B

Taxpayers are not required to include a Form 1095-B when filing their taxes.

Health insurers are no longer required to mail Form 1095-B to their members.

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