

You have completed at least 75% of the Mediterranean Wellness Program Curriculum and now are eligible to submit your claim to the FOREIGN SERVICE BENEFIT PLAN (FSBP)for reimbursement of the program fee of $140.00 (subject to availability).
Submitting Your Claim Is Easy: Simply complete the fields below, sign the form and send in your claim. Your claim will be processed under the Plan's Nutritional Counseling Benefit.
First Name: Cert.first
Last Name: Cert.last
Start Date: Cert.startdate
- Please submit your claim through one of the following methods:
- • Via our secure Web site (PDF only): https://www.afspa.org/site/insurance/fsbp/fsbp_askafspas_claim.html
- • Via e-mail: www.health@afspa.org
- • Via Mail: FOREIGN SERVICE BENEFIT PLAN1716 N Street, NWWashington, DC 20036-2902