You may download and submit a Request for Reimbursement form to Health Savings Administrators.
Send to us at this address:
Health Savings Administrators
10800 Midlothian Turnpike
Suite 240
Richmond, VA 23235
Or Fax it to: 804-726-1570
Reimbursements are withdrawn directly from your Mutual Fund and the reimbursement check will be made payable to you.


