For all questions regarding claims, receipt substantiations and general inquiries, please contact Customer Service at 1-844-516-3658.
You can track your FSA accounts online by logging on to HealthSmart. Read this for additional information regarding the HealthSmart portal. You may also track your accounts using the mobile app.
All claims and receipt substantiations can be submitted via fax to 1-844-319-3669 or mailed to: HealthSmart Benefit Solutions, PO Box 16647, Lubbock, TX 79490-6647
Forms:
- Health Care Flexible Spending Account (FSA) Reimbursement Claim Form - Submit this form for reimbursement of healthcare expenses.
- Dependent Care Flexible Spending Account (FSA) Reimbursement Claim Form - Submit this form for reimbursement of dependent care expenses.
- Life Status Change Event Form
- Requests for Additional (Dependent) Flex Benefit Card - If you would like an additional Flex Benefit Card(s) for a spouse and/or child, all requests must be submitted via the HealthSmart portal.
- Flexible Spending Direct Deposit Authorization Form - Submit this form if you'd like your reimbursements directly deposited into your bank account instead of getting a check mailed.
- Medical Necessity Form - Have your doctor complete this form to certify items and/or services that are potentially eligible based on medical necessity.