How do I submit a claim for an out-of-pocket LPFSA expense?
If you paid out of pocket for an expense that’s covered by your LPFSA, you can submit a claim to receive a reimbursement.
To submit a claim, follow these steps:
- Click on the Flexible Spending Account app on your dashboard.
- Click on the Claims tab at the top of the page.
- Click on the Submit a Claim button.
- Enter information about your expense and upload a receipt.
- Click Submit.
- Dependent Care FSA Claim Form
- Limited Purpose FSA Claim Form