Transcript Group Name - Choice Strategies

Group Name
Plan Year : 1/1/12-12/31/12
Find and Replace (Delete Slide before Presenting)
Getting Started: Enrollment presentations can be shown to
employees to help explain how to use their Choice Strategies
Plan in conjunction with their health insurance plan. Before
showing this presentation to employees, please customize it by
finding and replacing the following:
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Group Name : Group Name
Health Insurance Carrier : Carrier
Plan Year : 1/1/12-12/31/12
Plan Start Date : 1/1/11
HRA Single Deductible : $$$
HRA Family Deductible : $$$$
Carrier Single Deductible : $$$$$
Carrier Single Deductible : $$$$$$
FSA Maximum : $2500
Carrier Health Plan
• Carrier Health Plan Deductible:
– Single : $$$$$
– Family : $$$$$$
• Effective 1/1/12, Choice Strategies will be
administering:
– Health Reimbursement Arrangement (HRA)
– Flexible Spending Account (FSA)
– Dependent Care Account (DCA)
Health Reimbursement Arrangement (HRA)
Group Name’s HRA plan
• Plan Year: 1/1/12 – 12/31/12
• The HRA reimburses up to:
– Single: $$$
– Family: $$$$
• This money can be used for any expenses that
apply to your Carrier Deductible:
– Office Visits
– Hospital
– Prescriptions
– Outpatient, etc
Flexible Spending Account (FSA)
• You can elect up to $2500
• Plan Year: 1/1/12 – 12/31/12
• Pre-tax money, contributed through payroll
deductions
• “Use it or Lose it”
• Eligible expenses:
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Medical & Rx expenses
Dental Expenses
Vision Expenses
Limited OTC
Dependent Care Account (DCA)
• You can elect up to $5000
• Plan Year: 1/1/12 – 12/31/12
• Pre-tax money, contributed
through payroll deductions
• Pay as you go, can only spend
what you have contributed
• “Use it or Lose it”
• Eligible Expenses : Custodial Care of dependents while
employee is at work
Employee Savings Example
Without FSA/DCA
Gross Monthly Salary
$2,500.00
Less:
Federal Income Tax
$333.61
State Income Tax
$174.79
Social Security Tax
$191.25
Net Income
$1,800.35
Less:
Health Care Expenses
$200.00
Dependent Care
$400.00
Spendable Income
$1,200.35
With FSA/DCA
Gross Monthly Salary
Less:
Health Care Expenses
Dependent Care
Taxable Income
Less:
Federal Income Tax
State Income Tax
Social Security Tax
Spendable Income
Monthly Savings
Annual Savings
Based on 13.34% Federal Income Tax, 7% State Income Tax,
and 7.65% Social Security Tax Rate
$2,500.00
$200.00
$400.00
$1,900.00
$253.54
$132.84
$145.35
$1,368.27
$167.92
$2,015.04
About Your Choice Strategies Card
• It is a MasterCard
• Restricted to eligible
vendors / providers
• Must be swiped as a
Credit Card
• Cards arrive in a plain white envelope
• Spouses automatically get a card
• Additional cards can be issued upon request to
Member Services
Using Card for Medical Providers
Reminders :
• Do Not Pay on the Date of Service, wait until you
receive the Explanation of Benefits (EOB) from your
insurance company
• Always give your provider your Carrier ID card and
ask your provider to submit to insurance
Using Card at Pharmacy
Reminders :
• Check to make sure the pharmacy has your current
insurance information
• Use as credit card
Substantiation
Group Name is required by Federal Law to substantiate all claims. In
other words, the plan must prove that the purchases made with the
Choice Strategies card were for eligible expenses.
Keep all receipts when the Choice Strategies card is used
•Receipt Notification Process
•Employees are sent requests via mail or email to provide the
documentation for substantiation of transactions and claims
•Documentation
*EOBs
*Rx Receipts
*Provider Bills
•IIAS (Inventory Information Approval System)
•Merchants such as grocery stores, and pharmacies must be
able to differentiate between health eligible and ineligible items
at the point of purchase
•No Request for documentation if IIAS Approved
Pharmacy (List available on website)
Substantiation Service
HIPAA RELEASE FORM
• Voluntary Service that allows
Choice Strategies to view
Employees’ Explanation of Benefits
from online accounts with their
Carrier.
1. First, Employees must set-up
online account with Carrier
2. Employee fills out HIPAA Release
form with User ID and Password
3. When Employee uses Debit Card
for a transaction, Choice Strategies
logs in to Carrier Website and
matches charge to EOB
Available on Website
www.choice-strategies.com
End of Plan Year
Plan Year: 1/1/12-12/31/12
• Run-out Period - You have 3 months after the plan year
ends, to submit all outstanding claims for expenses that
occurred during the plan year. Reimbursement for these
expenses must be submitted manually through the claim
process.
• Example: If the plan year ends 12/31/11, you have until
3/31/12 to submit manual claims for dates of service that
occurred during your 2011 plan year. Do not charge your
Choice Strategies card. If card is charged in 1/12, the
transaction will pull from current plan year, 2012, funding. The
IRS does not allow previous plan year expenses to be paid
with current year funding.
Contacting Member Services
• Toll Free Phone : 1-(888)-278-2555
– Mon-Thurs
8:00 am – 7:00 pm EST
– Friday
8:00 am – 5:00 pm EST
• Email : [email protected]
• Live Chat : www.choice-strategies.com
– Mon-Thurs
– Friday
8:00 am – 4:45 pm EST
9:00 am – 4:45 pm EST
Check out the Website
www.choice-strategies.com
Online Account
• Check Account Balances • View Transaction History
• Submit Claims Online
• Upload Documentation
• Edit Direct Deposit Info
• Report Card Lost/Stolen
How to Submit a Claim Manually
• Online
– Login to Online Account
– Select “Request
Reimbursement”
– Fill out required fields
– Upload Documentation
– Select “Submit”
• Email, Fax, or Mail
– Fill out a Claim Form (available on website or by
contacting Member Services)
– Attach Documentation
Questions?