Human Resources

Claim Information

Making a Claim

There are three main factors to consider when making a claim:

Date of the expense incurred

Expenses incurred by March 15th may be claimed as expenses for the previous plan year if you were enrolled. Expenses incurred after March 15th of a year, may only be claimed as expenses for that plan year.

Required documentation

The following documentation must accompany your claim:

Dependent Care expenses
Proof that you have paid the expenses in-full for the services you are claiming.

Healthcare expenses
Proof that you have received the services and proof of what expense is your responsibility.

Copies of insurance explanations of benefits statements may be used instead of original physician bills if the date of service and charges are shown. Copies of receipts of payment that do not include all the above information are not acceptable. Copies of personal checks are not acceptable. Documentation or copies will not be returned.

Date of claim

Claims filed no later than April 15th, may be applied to the previous year's plan expenses. After that, your previous year account will be closed and any unclaimed balance will be forfeited by you and will be retained by the State in accordance with federal regulations.

A supply of claim forms is included with your enrollment confirmation. Extra claim forms are available through your personnel assistant or you may download the form here.

Receiving Reimbursement (payment from ASI)

ASI will review your claim and if approved, will reimburse you for the covered expenses. ASI will pay all claims incurred between January 1 and March 15 with any remaining previous plan year dollars first. Payments are generally issued within one day of ASI’s receipt of your claim. Your bi-weekly contributions will continue for the remainder of the Plan year.

Dependent Care-if your claim exceeds your available funds (contributions already made), the difference will be recorded and paid to you as funds become available from future payroll

Healthcare- payment is not limited to the amount in your account at the time of your claim but is limited to your annual election amount

Reimbursement may be received by direct deposit into the bank account of your choice. By using direct deposit you don't need to wait for a check to arrive or get it deposited. A notice that a payment was made will be sent to you. This direct deposit notice is available by U.S. Mail or by e-mail over the Internet.

If you prefer, a check can be mailed to you instead of payment by direct deposit.