Citi Benefits Handbook
Filing a Claim
See "How to File a Claim" in the Eligibility and Participation section.
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 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 Optum Financial payment card. For example, you will have until June 30, 2024, to file claims for reimbursement of expenses incurred in 2023.
For the fastest results, use your Optum Financial payment card to directly pay for eligible health care expenses. You can also submit claims as follows.
Online
  • Log on to the Optum Financial website through My Total Compensation and Benefits at www.totalcomponline.com.
  • To request reimbursement for an out-of-pocket expense, click on the "Reimburse Myself" button at the top of the page.
  • Complete the online form.
  • Follow the screen prompts to submit documentation, choosing either "upload documentation" or "fax documentation." If you are faxing documentation, follow the screen prompts to print out the fax cover form to use when submitting the documentation.
Mobile App
  • Download the Optum Financial mobile app from your app store.
  • Log in using your online username and password. If you have never logged in before, click "New User Registration" to set your username and password.
  • Tap the option to submit a new payment request.
  • Follow the screen prompts to submit information.
  • Follow the screen prompts to submit documentation using your camera or select an image from your mobile device.
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 (443) 681-4602. 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:
Claims Department
PO Box 622317
Orlando, FL 32862-2317
If your LPSA claim is denied, see "Claims and Appeals for the Health Care Spending Account (HCSA)/Limited Purpose Health Care Spending Account (LPSA)."