Tools
Check your FSA, HRA or T&P account information here:
Pop-Up Windows 
Links to our PDF forms, documents, external resources and some help items are set to open in new browser windows. You may need to set your browser's pop-up blocker to accept pop-up windows for this site.
Eligible Expense List
What expenses are eligible for reimbursement under a cafeteria/flex plan?
Tax Calculator
How much can you save in taxes by participating in cafeteria/flex and transit & parking plans?
Entering your claim online is quick and convenient:
Participants/Employees
FSA Claim Forms
Enter your claims directly into our system. Then simply fax the claim transmittal form and your supporting documentation to Creative Benefits. Your claim will be reviewed in record time!
- FSA Spending Account Claim Form
Download a Spending Account claim form - DCSA Placeholder Claim Form
Download for use with Payment Card and Dependent Care Spending Account - Spending Account Claim Form Spanish version
Download a Spending Account claim form in Spanish - Alternate Insurance Premium Claim Form Download an Alternate Insurance Premium Claim Form
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Additional Claim Documentation
- Letter of Medical Necessity
Download and take to licensed provider - Healthcare Dispute Form - VISA
To report credit card fraud - Receipt for Day Care Expenses
Download a receipt for your Day Care Expenses -
How to Submit a Claim
- 3 Easy Steps to Submit a Claim
How to submit a claim form - Example Claim Form
Example of a completed claim form - 3 Easy Steps to Submit a Claim Spanish version
How to submit a claim form in Spanish - Example Claim Form Spanish version
Example of a completed claim form in Spanish
Daily Claim Processing:
Claims received in our office before 2:00 pm Pacific Time will be processed by end of business day. You can verify the receipt and entry of your claims by accessing Your Account online or calling 1-888-295-5656 and following the prompts.
Claims received after 2:00 pm Pacific Time will be processed the next business day.
PDF Help
Having trouble downloading/opening a PDF file?
First: Set your browser to allow pop-up windows for this site. Second: Update your Adobe Reader. Get the latest version available from Adobe (it's free).
Next: Try this work-around from Adobe to save the PDF file to your hard drive and open in Adobe Reader:
- Right-click the link to the PDF file and then choose Save Target As (Internet Explorer) or Save Link As (Netscape Navigator).
- In the Save As dialog box, select a location on the hard disk, and then click Save.
- Double-click the PDF file to open in Adobe Reader.
More Help: You can access the Adobe site here.
Click on "Support" and then select "Help with the Free Adobe Reader Software."
Still unable to download a claim form? Click below to receive an FSA claim form as an attachment through automated response. You must be able to receive attachments in your email. This email is not monitored and returns only the Flexible Spending Account claim form. If another claim form is needed, please email Research for specifics.
E-mail us to request a claim form if you are unable to download.
If the above link does not work, you can open your email program, then copy and paste the form email address into your recipient line: Form@creativebenefits.com.
Send with no message required to receive the automated response.