Claims submitted online do not require a separate claim form as you will enter the claim information directly on the site. If you prefer to submit your claims via fax or mail, then a claim form will be required and should be submitted to the Judiciary Benefits Center for processing. Click on the link to download a Health Care Claim Form, a Dependent Care Claim Form or a Commuter Parking Claim Form.
Online: Log in to your account, select "Reimbursement Accounts", then select “Submit a Claim" and follow the step-by-step instructions.
Fax: Fax your claim form and documentation to the Judiciary Benefits Center 24-Hour Fax line at 1-800-778-0045.
Mail: Mail your claim form and documentation to the Federal Judiciary Benefits Program, PO Box 35680, Louisville, KY 40232