How to Submit a TSB Claim
Claim form
- TSB-HRA Claim Form (PDF)
When to submit
- Claims will be honored for services received from the date of your reduction agreement through December 31 of the Plan year or the grace period of January and February following the end of the plan year.
- Eligible claims may be submitted at any time during the plan year or grace period, but no later than April 15 following the end of the plan year.
By e-mail
By U.S. mail or fax
Attn: Claim Reimbursement
The Nyhart Company, Inc.
8415 Allison Pointe Boulevard, Suite 300
Indianapolis, IN 46250-4201
Fax: (888) 887-9961
Questions
If you have questions about allowable expenses or making a claim, contact The Nyhart Company Claim Center at 800-284-8412.
