Flexible Spending Accounts

Filing Your Claim

In order to ensure prompt payment of your claim, it is important for you to provide all required information. 

ELECTRONIC PAYMENT CARD (Health Care Expenses Only)
You do not need to file a claim when you use your Electronic Payment Card to pay for an eligible health care expense (see FSA Card under Health Care Flexible Spending Account Reimbursement). However, it is important for you to save your receipts or other statements as proof of payment for eligible health care expenses. 

ALL OTHER CLAIMS
You can submit your claims for health care and/or dependent care reimbursement at any time. 

As mentioned above, you do not need to file a claim when you use your Electronic Payment Card to pay for an eligible health care expense. All other claims for Flexible Spending Account Plan reimbursement must include: 

  • a completed FSA Claim Form, which you can obtain from the Company Intranet or the Flexible Spending website at www.flexdirect.adp.com;
  • itemized bills, receipts, or other proof of payment* for eligible services or expenses showing:
    • the name of the provider
    • nature of the expense;
    • the date the expense was incurred;
    • the amount of the expense; and
  • in the case of a claim for dependent care reimbursement, the name, address, and Social Security number (or Taxpayer Identification Number) of the dependent care provider. 

*Canceled checks will not be accepted. 

The Claim Administrator may also request that you provide additional documentation to support your claim. 

You may continue to submit claims for a limited period after your participation ends. This is explained below.

CLAIM FILING DEADLINE
The deadline for filing your claim for eligible health care and/or dependent care expenses is March 31 of the following year. For example, suppose you have eligible dependent care expenses for services that were incurred during the 2017 calendar year. You have until March 31, 2018 to submit your claim and proof of payment for these expenses. 

Health Care Expenses: See the "Claim Filing Deadline" information in the Health Care Flexible Spending Account Reimbursement section for additional information and an example illustrating the claim filing deadline for eligible health care expenses. 

WHERE TO SEND YOUR CLAIM
To expedite processing, you should fax your claims for Flexible Spending Account Plan reimbursement to ADP at 1-866-392-4090 or send them to the following address: 

ADP Claims Processing
PO Box 1853
Alpharetta, GA 30023-1853

DENIED CLAIMS
You can appeal a denied claim. The claim appeal procedures are described in the Administrative Information section of this SPD.