Citi Benefits Handbook
Filing a Claim
Generally, you will have until June 30 following the year in which you incur the eligible expense to file and resolve a claim for reimbursement. In order for a claim to be deemed an eligible expense to be reimbursed, you must provide any pertinent documentation to establish that a claim is eligible for reimbursement, which may include providing documentation that a service provided in connection with a claim was medically necessary. All such documentation must be submitted and resolved by the June 30 deadline to avoid the amount being subject to forfeiture or included in taxable income in connection with the CYC payment card. For example, you will have until June 30, 2018, to file claims for reimbursement of expenses incurred in 2017.
For the fastest results, use your CYC payment card to directly pay for eligible health care expenses. You can also submit claims as follows:
Online
  • Log on to the CYC website through TotalComp@Citi at www.totalcomponline.com.
  • To request reimbursement for an out-of-pocket expense, under "Payments and Reimbursements," select "Create a New Reimbursement:"
  • To request that payment is made directly to your provider, under "Payments and Reimbursements," select "Create a New Payment:"
Note to LPSA participants: The system will guide you through uploading the appropriate information about your visit and documentation to complete the reimbursement. The system will automatically pull funds first from your LPSA if it is an eligible dental or vision expense, and from your HSA if it is for an eligible medical or prescription drug expense.
Paper Claim Submission
  • To submit a paper claim, complete the Manual Claim Form.
  • Fax the Manual Claim Form with itemized receipts or other documentation to 1-866-892-8063. Remember to keep the original claim form and supporting documents for your records.
  • If you choose to mail your claim form and required documentation for reimbursement (instead of faxing), the address is:
ConnectYourCare Claims Department
P.O. Box 622317
Orlando, FL 32862-2317