Help | Log In
ProBenefits.com Benefits Portal


Loading

File a Reimbursement Claim

  FSA

Fill and Print FSA Claim Form Print a Blank FSA Claim Form

Complete the form and submit to ProBenefits along with appropriate documentation.
Learn more about filing FSA Reimbursement Claims.


  HRA/MERP

Fill and Print HRA/MERP Claim Form Print a Blank HRA/MERP Claim Form

Complete the form and submit to ProBenefits along with appropriate documentation (in most cases, an insurance Explanation of Benefits, or EOB, is required).