Plans & Services

General Information
File A Claim
Sample EOBs
HRA Forms

How do I submit an HRA claim to Flex Administrators for reimbursement?

  • Whenever an eligible medical expense is incurred, you will receive an Explanation of Benefits (EOB) from your insurance company. This will usually come before the bill from the provider.
  • The EOB will say, “This is NOT a Bill”, but you will need to save it for reimbursement.
  • If dental, optical, prescription, and/or other expenses are eligible for reimbursement through your HRA, simply submit an itemized receipt that includes the following:
    1. Patient name
    2. Date of service
    3. Description of service
    4. Provider name and address
    5. Amount of the expense that you are responsible for

For prescription reimbursement, a cash register receipt is acceptable.

  • Fill out a “Request for Reimbursement” form. It is important to fill out the top and sign the bottom.
  • Submit the form and your EOB to Flex Administrators, Inc. by one of the following methods:
    1. Fax
    2. Mail
    3. e-mail to:
    4. Submit through the Mobile App - iOS / Android
    Both the fax numbers and mailing address are listed on the bottom of the reimbursement form. Your eligible claim will be processed and payment(s) sent.

If you ever have any questions about what you can or cannot submit, or about any other part of the process, please contact Flex Administrators, Inc. at (616) 456-7908 or toll free at 1 (800) 968-3539.

Can I use one reimbursement form for HRA & FSA plans?

Yes, you can use one reimbursement form when submitting a claim for both HRA and FSA eligible items. Your account manager with Flex Administrators, Inc. knows your benefit order and will process the payment accordingly.