Healthcare Spending Account (HCSA)
If you have coverage through your employer
Submit your claims online
GroupNet makes it quick and easy to submit your claims online or print forms that are pre-filled with your personal information. You can also sign up for direct deposit, view coverage information and much more.
Still need to sign up? It’s simple and only takes a few minutes.
Register - Opens in a new windowDownloadable forms
Use these forms to claim expenses if your plan includes a healthcare spending account. Select the form applicable to your claim type.
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If your plan includes a healthcare spending account, use this form to make a healthcare claim or get an estimate for healthcare expenses.
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If your plan includes a healthcare spending account, use this form to make a claim for dental expenses. You'll need the dentist to fill in some sections.
Not the forms you're looking for? Go back to the find a form page.