• Medical Claim Forms

    Medical Claim form for Out-of-Network Provider or Massage Therapy


    Directions on Submitting Medical Claim form to HNAS


    Phone: 800-220-2600

    Website: www.myhnas.com

    Email: claims.hnas@hnas.com

    Group: U44

  • Massage Therapy Reimbursement

    If you are enrolled in HMC medical plan, the plan offers massage therapy benefit and does not require referral from a physician. The only requirement is that your massage therapist is licensed in the state of service.


    Click Here for directions on how to file claim for reimbursement. 


    $700.00 benefit per Calendar year. Applies to both employee and spouse in the HMC medical plan.


    o $25 Copay for Standard PPO and EPO plan.

    o $35 Copay for Choice and HSA PPO plan.




  • Dental Claim Form

    The Dental Claim form applies to the Dental PPO plan Only. If your dentist is an out-of-network provider and does not submit your service to the insurance company, please complete form to receive your dental benefit.


    Dental Claim Form


    Directions on Filing Dental Claim Form


    Phone: 800-765-6003

    Website: deltadentalins.com

    PPO Group number: 00511



  • Vision VSP Claim Form

    Submit a claim with VSP if you visit an Out-of-Network provider.


    Directions to filing a VSP claim


    Phone: 800-877-7195

    Website: www.vsp.com

    Group number: 30058404

  • FSA Tax Spending Claim Form

    If you did not use your FSA debit card or if HNAS requires documentation for the debit card you used, please submit documentation or claim to the FSA website.


    Directions on Setting up an Account with HNAS FSA


    Filing medical or dependent care claim.


    FSA Customer Service Number: 800-518-8332

    Email: hnasfsaclaims@hnas.com

    Website: HNAS.wealthcareportal.com