Please find online account instructions and frequently asked questions below for your convenience.

​

• Online Account Instructions - Please follow these instructions to create and register your accounts online.
   

• DCA Frequently Asked Questions - A few frequently asked questions for the Dependent Care Account.

​

Once you have completed any of the claim forms listed below, you may either upload them at your online portal along with any substantiation or email it all to service@healthydollarsinc.com for processing.

​

• Manual Claim Form - To be completed when submitting for reimbursement or direct to provider payment. Must be accompanied by a detailed statement and/or explanation of benefits when applicable. 
   

• Dependent Care Account Claim Form - Complete for daycare services that occur throughout the year (daycare, preschool).

​

Any of the forms listed below can be completed and emailed to service@healthydollarsinc.com for processing.

​

• Letter of Medical Necessity Form - Please have this form completed by your doctor for items that you need to be covered by you FSA or HSA funds which are normally considered ineligible.
   

• ACH Form (Direct Deposit) - Complete this form in order to have claim reimbursements directly deposited into your checking or savings account.

The enrollment forms must be completed and submitted to your Human Resource department.

​

• Enrollment Form - HRA Healthcare Reimbursement Account
   

• Enrollment Form - FSA Flexible Spending Account
   

• Enrollment Form DCA Dependent Care Account