Transcript Employee Pay First HRA

Group Name
Employer ID: CHO
Plan Year: 01/01/2015-12/31/2015
Presented By: Name
Title
Instructions: Find and Replace
Delete This Slide Before Presenting
Getting Started:
Enrollment presentations can be shown to employees to help
explain how to use their Choice Strategies plan.
• Before showing this presentation to employees, please
customize it by finding and replacing the following:
Group Name: Group Name
Health Insurance Carrier: Carrier
Plan Year: 01/01/2015-12/31/2015
Plan Start Date: 01/01/2015
HRA Single Out-of-Pocket Responsibility: $$$$$
HRA Family Out-of-Pocket Responsibility: $$$$$$
HRA Single Funding: $
HRA Family Funding: $$
Carrier Single Deductible: $$$
Carrier Family Deductible: $$$$
FSA Maximum: $2,550
Your Health Plan
Carrier
Deductible:
• Single: $$$
• Family: $$$$
Effective 01/01/2015, Choice
Strategies will be
administering:
• Health Reimbursement Arrangement
(HRA)
• Flexible Spending Account (FSA)
• Dependent Care Account (DCA)
Health Reimbursement Arrangement
HRA
Group Name’s HRA Plan:
• Plan Year: 01/01/2015-12/31/2015
• BEFORE funds are available in the HRA
for use, you must pay the following
amount of Carrier deductible expenses
out-of-pocket. This is called your HRA
Deductible:
– Single: $$$$$
– Family: $$$$$$
• AFTER you pay the HRA deductible outof-pocket, the HRA reimburses up to:
– Single: $
– Family: $$
Health Reimbursement Arrangement
HRA
Group Name’s HRA Plan:
• To activate the account once HRA deductible
has been satisfied:
– Submit a claim and attach supporting documentation
– Claims can be submitted through your online account
or claim forms are available under the “For Members”
tab and “Forms” page on www.choice-strategies.com
• HRA-Eligible Expenses include:
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Office Visits
Hospital
Prescriptions
Outpatient
End of Plan Year
Health Reimbursement Arrangement
3 Month 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
Plan Year: 01/01/2015-12/31/2015
Reimbursement for these expenses must be submitted manually through
the claim process during the Run-Out Period
Do NOT charge your Choice Strategies Card for dates of service the occurred
during a previous plan year.
Example: Plan year ends on 12/31/15. You have until 3/31/2016 to submit
manual claims for dates of service that occurred during the 2015 calendar
plan year.
Flexible Spending Account
FSA
You can elect to contribute up to $2,550 pre-tax
• Plan Year: 01/01/2015-12/31/2015
• Contributed through payroll deductions
• “Use it or Lose it”
• Eligible Expenses:
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Medical
Dental
Vision
Prescriptions
Limited Over-the-Counter (OTC) products
End of Plan Year
Flexible Spending Account
2 ½ Month Grace Period
• You have 2 ½ months after the FSA plan year ends to use any
remaining funds for expenses that occurred within the current plan
year or during the grace period
• Plan Year: 01/01/2015-12/31/2015
• You may use your card for FSA eligible expenses during the grace period
for any expenses incurred between the beginning of your plan year and
the end of the grace period
• Example: Plan year ends on 12/31/15. You have until 3/15/2016 to use
remaining FSA funds for dates of service that occurred during the 2015
plan year and through the Grace Period.
End of Plan Year
Flexible Spending Account
The FSA Carryover
What is it? A provision for FSAs that allows up to $500 to carryover
from year to year.
Will the carryover amount effect the amount that can be
elected pre-tax for the next plan year? No.
So, if the carryover is $500 from a previous year, the available
balance for the new year could be anything up to $3,050? Yes.
Dependent Care Account
DCA
You can elect to contribute up to:
• $2,500 if married, filing separate tax returns
• $5,000 if single OR married, filing jointly
• Plan Year: 01/01/2015-12/31/2015
• Contributed through payroll deductions
– Pre-tax!
• Pay as you go
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You can only spend what you have contributed.
• 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
Based on 13.34% Federal Income Tax, 7%
State Income Tax, and 7.65% Social
Security Tax Rate
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
$2,500.00
$200.00
$400.00
$1,900.00
$253.54
$132.84
$145.35
$1,368.27
$167.92
$2,015.04
Choice Strategies Card
The Facts
• MasterCard
• Card activates upon first use
• If balance available and any shared responsibility portions
have been met
• Employee and spouse automatically receive cards
• Separate envelopes
• Additional cards can be issued upon request
• Swipe as CREDIT vs. Debit for convenience
• If needed - PIN is accessible through Member Online
Accounts under the My Card tab.
Using the Card
Medical Providers
Do not pay on the date of service,
wait until you receive the Explanation
of Benefits from Carrier.
Using the Card
Prescriptions
IIAS (Inventory Information Approval System)
No Request for documentation on Rx charges if IIAS Approved
Pharmacy is used. (List available on www.choice-strategies.com)
Submitting a Claim
Need Reimbursement?
• Online – Faster Reimbursement!
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Login to your Online Account
Select “Submit a Claim”
Fill our required fields
Upload Supporting documentation
Select “Submit”
• Email, Fax, or Mail
– Fill out a Claim Form available under the “For
Members” and “Forms” page on www.choicestrategies.com
– Attach supporting documentation
Substantiation Requirements
Documentation Requests
Group Name is required by Federal Law to substantiate all
claims.
• This means that purchases made with your Choice Strategies Card need to
be supported with documentation
Receipt Notification Process:
• Employees are sent requests via mail or email
to provide documentation on card
transactions.
• Supporting documentation requested may
include:
– Explanation of Benefits (EOB)
– Rx Receipts
– Provider Bills
Substantiation Service
Free and Voluntary
Allows Choice Strategies to view your Explanation of Benefits from the
online account with Carrier
Signing Up:
1) You must set up an online account with
Carrier
2) Sign up for the Substantiation Service by
provider your Carrier User ID and Password
to Choice Strategies
• Use the online HIPAA Release Form under the
“For Members” section and forms page on
www.choice-strategies.com
To take advantage of our Substantiation Service, enroll online at:
www.choice-strategies.com/substantiation-enrollment
Member Online Accounts
www.choice-strategies.com
Helpful Features!
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Check available balance
Review transaction history
Upload supporting documentation
Verify the Choice Strategies Card status
Update personal information
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Email, home address, phone number
• Submit claims online
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Reimbursement method
Video tutorial available
Mobile App
Access Your Information on the Go!
Available For iOS and Android
You Can:
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Create Account
Check available balance
Review transaction history
Submit claims
Upload supporting documentation
Video tutorial available
We are Here to Help!
Phone: 888-278-2555 (Option 2)
Hours: Monday-Friday
8:00am – 8:00pm EST