Citi Benefits Handbook
Filing a Claim
Generally, you will have until June 30 following the year in which you incur an eligible expense to file and resolve a claim for reimbursement. 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. All such documentation must be submitted and the claim must be resolved by the deadline to avoid forfeiture of the funds in your DCSA.
Follow the instructions below to submit a claim based on the option you choose.
  • Log on to the Optum Financial website through My Total Compensation and Benefits at
  • To request reimbursement for an out-of-pocket expense, click on "Reimburse Myself."
  • 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
  • Obtain an itemized statement from your dependent care provider containing the required information (provider's name, dependent's name, service period, payment amount and type of care provided). Alternatively, ask your provider to complete the Provider Information section on the Dependent Care Account Claim and Provider Documentation Form.
  • Fax the form with receipts and required 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 form and required documentation (instead of faxing), the address is:
Claims Department
PO Box 622337
Orlando, FL 32862-2337
If your DCSA claim is denied, see "DCSA and TRIP Denials."
Note: You cannot submit claims for services that have not yet been rendered. Claims submitted in advance will be denied as ineligible, and you will need to resubmit them to be reimbursed after the services have been provided.