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 . 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 .
- 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.