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FSA/HRA REIMBURSEMENT CLAIM FORM(Please Print Clearly)Page 1Want your reimbursement faster? File your claim online via the employee portal (www.BRiWeb.com) or via the Mobile app, if allowed by your
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How to fill out file your claim online

01
Open your web browser and go to the claim filing website.
02
Create an account or log in if you already have one.
03
Click on the 'File a Claim' button.
04
Select the type of claim you want to file from the options provided.
05
Fill out the required information in the claim form, such as personal details, incident details, and supporting documents.
06
Review the information you provided and make sure everything is accurate and complete.
07
Submit the claim by clicking on the 'Submit' button.
08
Wait for a confirmation message or email that your claim has been successfully filed.
09
Keep track of your claim's progress and follow up with any additional information or documents as requested.
10
Once your claim is processed, you will receive a response regarding the outcome and any further steps necessary.

Who needs file your claim online?

01
Anyone who has experienced an incident that is covered by their insurance policy and wants to file a claim online can benefit from filing their claim online.
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Filing your claim online refers to submitting your claim electronically through a designated platform or website.
Individuals or entities who are eligible to file a claim and have access to an online filing system are required to file their claims online.
To fill out your claim online, you need to navigate to the designated website, create an account if necessary, provide the required information, and submit your claim electronically.
The purpose of filing your claim online is to streamline the claims process, increase efficiency, reduce paperwork, and provide a convenient way for claimants to submit their claims.
When filing your claim online, you must report information such as your personal details, the nature of your claim, any supporting documentation, and any other relevant information requested by the system.
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