To receive payment for EAP services rendered, you must complete the Employee Assistance Service Information (EASI) form.
Online EASI Form -- Use the online application to conveniently and easily submit your EASI forms. Simply sign in with your secure username and password, and click on Submit an EASI Form on the left-hand menu (under My Claims).
EASI Form -- hard copy for faxing or mailing (PDF)
EASI Form Instructions (PDF)
EAP Reimbursement Contact Information (PDF)
You must submit the EASI form within 90 days of the end date indicated on the referral sheet, found in the EAP member registration packet for each specific case. Please refer to the EAP registration packet for the specific billing address.
EAP EFT Form (PDF) -- to request electronic funds transfer to your bank account
You can find information about Employee Assistance Program (EAP) Reimbursement in section 7 of the EAP Handbook Supplement (PDF).