Presentation on theme: "Group Name Employer ID: CHO Plan Year: 01/01/2015-12/31/2015 Presented By: Name Title."— Presentation transcript:
Group Name Employer ID: CHO Plan Year: 01/01/ /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/ /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: $$$$ Effective 01/01/2015, Choice Strategies will be administering: Health Reimbursement Arrangement (HRA) Flexible Spending Account (FSA) Dependent Care Account (DCA)
Health Reimbursement Arrangement HRA Group Name’s HRA Plan: Plan Year: 01/01/ /31/2015 BEFORE funds are available in the HRA for use, you must pay the following amount of Carrier deductible expenses out-of-pocket. This is called your HRA Deductible: –Single: $$$$$ –Family: $$$$$$ AFTER you pay the HRA deductible out- of-pocket, the HRA reimburses up to: –Single: $ –Family: $$
Health Reimbursement Arrangement HRA 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 HRA-Eligible Expenses include: –Office Visits –Hospital –Prescriptions –Outpatient Group Name’s HRA Plan:
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/ /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 Plan Year: 01/01/ /31/2015 Contributed through payroll deductions “Use it or Lose it” Eligible Expenses: Medical Dental Vision Prescriptions Limited Over-the-Counter (OTC) products You can elect to contribute up to $2,550 pre-tax
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/ /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 Will the carryover amount effect the amount that can be elected pre-tax for the next plan year? No. What is it? A provision for FSAs that allows up to $500 to carryover from year to year. 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 Plan Year: 01/01/ /31/2015 Contributed through payroll deductions –Pre-tax! Pay as you go – You can only spend what you have contributed. Eligible Expenses: –Custodial care of dependents while employee is at work You can elect to contribute up to: $2,500 if married, filing separate tax returns $5,000 if single OR married, filing jointly
Employee Savings Example Based on 13.34% Federal Income Tax, 7% State Income Tax, and 7.65% Social Security Tax Rate
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
Submitting a Claim Need Reimbursement? Online – Faster Reimbursement! –Login to your Online Account –Select “Submit a Claim” –Fill our required fields –Upload Supporting documentation –Select “Submit” , Fax, or Mail –Fill out a Claim Form available under the “For Members” and “Forms” page on strategies.comwww.choice- strategies.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 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 To take advantage of our Substantiation Service, enroll online at:
Member Online Accounts Helpful Features! Check available balance Review transaction history Upload supporting documentation Verify the Choice Strategies Card status Update personal information , home address, phone number Submit claims online Reimbursement method Video tutorial available
Mobile App Access Your Information on the Go! Available For iOS and Android Video tutorial available You Can: Create Account Check available balance Review transaction history Submit claims Upload supporting documentation
We are Here to Help! Phone: (Option 2) Hours: Monday-Friday 8:00am – 8:00pm EST