Presentation on theme: "Group Name Employer ID: CHO Plan Year: 01/01/ /31/2015"— Presentation transcript:
1Group Name Employer ID: CHO Plan Year: 01/01/2015-12/31/2015 Presented By: NameTitle
2Instructions: 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 NameHealth Insurance Carrier: CarrierPlan Year: 01/01/ /31/2015Plan Start Date: 01/01/2015HRA Single Out-of-Pocket Responsibility: $$$$$HRA Family Out-of-Pocket Responsibility: $$$$$$HRA Single Funding: $HRA Family Funding: $$Carrier Single Deductible: $$$Carrier Family Deductible: $$$$FSA Maximum: $2,550
3Your Health Plan Carrier Deductible:Single: $$$Family: $$$$Effective 01/01/2015, Choice Strategies will be administering:Health Reimbursement Arrangement (HRA)Flexible Spending Account (FSA)Dependent Care Account (DCA)
4Health Reimbursement Arrangement HRA Group Name’s HRA Plan:Plan Year: 01/01/ /31/2015BEFORE funds are available in the HRA for use, you must pay the following amount of Carrier deductible expenses out-of-pocket. This is called your HRA Deductible:Single: $$$$$Family: $$$$$$AFTER you pay the HRA deductible out-of-pocket, the HRA reimburses up to:Single: $Family: $$
5Health Reimbursement Arrangement HRA Group Name’s HRA Plan:To activate the account once HRA deductible has been satisfied:Submit a claim and attach supporting documentationClaims can be submitted through your online account or claim forms are available under the “For Members” tab and “Forms” page onHRA-Eligible Expenses include:Office VisitsHospitalPrescriptionsOutpatient
6End of Plan Year Health Reimbursement Arrangement 3 Month Run-Out PeriodYou have 3 months after the plan year ends to submit all outstanding claims for expenses that occurred during the plan yearPlan Year: 01/01/ /31/2015Reimbursement for these expenses must be submitted manually through the claim process during the Run-Out PeriodDo 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.
7Flexible Spending Account FSA You can elect to contribute up to $2,550 pre-taxPlan Year: 01/01/ /31/2015Contributed through payroll deductions“Use it or Lose it”Eligible Expenses:MedicalDentalVisionPrescriptionsLimited Over-the-Counter (OTC) products
8End of Plan Year Flexible Spending Account 2 ½ Month Grace PeriodYou 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 periodPlan Year: 01/01/ /31/2015You 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 periodExample: 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.
9End of Plan Year Flexible Spending Account The FSA CarryoverWhat 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.
10Dependent 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 jointlyPlan Year: 01/01/ /31/2015Contributed through payroll deductionsPre-tax!Pay as you goYou can only spend what you have contributed.Eligible Expenses:Custodial care of dependents while employee is at work
11Employee Savings Example Without FSA / DCAGross Monthly Salary$2,500.00Less:Federal Income Tax$333.61State Income Tax$174.79Social Security Tax$191.25Net Income$1,800.35Health Care Expenses$200.00Dependent Care$400.00Spendable Income$1,200.35With FSA/DCAGross Monthly Salary$2,500.00Less:Health Care Expenses$200.00Dependent Care$400.00Taxable Income$1,900.00Federal Income Tax$253.54State Income Tax$132.84Social Security Tax$145.35Spendable Income$1,368.27Monthly Savings$167.92Annual Savings$2,015.04Based on 13.34% Federal Income Tax, 7% State Income Tax, and 7.65% Social Security Tax Rate
12Choice Strategies Card The Facts MasterCardCard activates upon first useIf balance available and any shared responsibility portions have been metEmployee and spouse automatically receive cardsSeparate envelopesAdditional cards can be issued upon requestSwipe as CREDIT vs. Debit for convenienceIf needed - PIN is accessible through Member Online Accounts under the My Card tab.
13Using the Card Medical Providers Present Your Health Insurance ID Card.CompleteVisitProvider Will Submit Claim To Health InsuranceHealth Insurance adjusts claim and generates Explanation of BenefitsYou will receive an EOB from your Health Insurance and a doctors billDo not pay on the date of service, wait until you receive the Explanation of Benefits from Carrier.Pay with your Choice Strategies Card!
14Using the Card Prescriptions Doctor writes a Prescription (Rx) and gives to you.Bring Rx to pharmacy.(Make sure updated Carrier information is on file)Pharmacist advises price of Rx.Employee pays with Choice Strategies Card!IIAS (Inventory Information Approval System)No Request for documentation on Rx charges if IIAS Approved Pharmacy is used. (List available on
15Submitting a Claim Need Reimbursement? Online – Faster Reimbursement!Login to your Online AccountSelect “Submit a Claim”Fill our required fieldsUpload Supporting documentationSelect “Submit”, Fax, or MailFill out a Claim Form available under the “For Members” and “Forms” page onAttach supporting documentation
16Substantiation 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 documentationReceipt 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 ReceiptsProvider Bills
17Substantiation Service Free and Voluntary Allows Choice Strategies to view your Explanation of Benefits from the online account with CarrierSigning Up:You must set up an online account with CarrierSign up for the Substantiation Service by provider your Carrier User ID and Password to Choice StrategiesUse the online HIPAA Release Form under the “For Members” section and forms page onTo take advantage of our Substantiation Service, enroll online at:
18Member Online Accounts www.choice-strategies.com Helpful Features!Check available balanceReview transaction historyUpload supporting documentationVerify the Choice Strategies Card statusUpdate personal information, home address, phone numberSubmit claims onlineReimbursement methodVideo tutorial available
19Mobile App Access Your Information on the Go! Available For iOS and AndroidYou Can:Create AccountCheck available balanceReview transaction historySubmit claimsUpload supporting documentationVideo tutorial available
20We are Here to Help! Phone: 888-278-2555 (Option 2) Hours: Monday-Friday8:00am – 8:00pm EST