You have three options to submit your HCRA and/or HRA reimbursement request and required supporting documentation:

1. To file electronically and prevent delay, submit your claim directly to the Trust, click here.
2. To file through Contact Us on the Trust website, complete and upload the appropriate form below along with any required documentation to Contact Us, or
3. Complete the appropriate form below and mail or fax it along with any required documentation to the Trust Administrator's office using the mailing address or fax number listed at the top of the form.
   • Health Care HCRA Reimbursement Account (HCRA) Form
   • Health Reimbursement Arrangement Plan (HRA) Form (for participants enrolled in Plan D)