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Group Name Employer ID: CHO Name Here Title Here.

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Presentation on theme: "Group Name Employer ID: CHO Name Here Title Here."— Presentation transcript:

1 Group Name Employer ID: CHO Name Here Title Here

2 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: 00/00/ /00/0000 Plan Start Date: 00/00/0000 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: $2,600

3 Your Health Plan Carrier
Deductible: Single: $$$ Family: $$$$ Effective 00/00/0000, Choice Strategies will be administering: Health Reimbursement Arrangement (HRA) Flexible Spending Account (FSA) Dependent Care Account (DCA)

4 Health Reimbursement Arrangement (HRA) Plan Year: 00/00/0000-00/00/0000
Key Features Funding Eligible Expenses Employer funded Funds used are tax deductible to employer Tax free to the employee Implementation in combination with High Deductible Health Plan helps to lower costs BEFORE funds are available in the HRA for use, you must pay the following deductible expenses out-of- pocket. Single: $$$$$ Family: $$$$$$ AFTER you pay the HRA deductible out-of- pocket, the HRA reimburses up to: Medical Deductible Copays Coinsurance Prescriptions

5 How is the deductible tracked?
Deductible not satisfied Submit expenses via manual claims as you pay them out of pocket Choice Strategies will track how much has been paid towards your deductible You must continue to submit expenses as you pay them Deductible satisfied HRA funds are now available for use

6 What supporting documentation should I send?
Explanation of Benefits (EOB) Statement from your health insurance company detailing your responsibility as the patient (deductible) and the insurance adjustments made. Provider Bill or Statement A detailed bill or statement from your doctor's office that details the date of service, procedures performed, amount due, doctor’s name, insurance adjustments, etc.

7 How do I claim the available HRA funds?
Provider Pay: Choice will automatically issue payment via check to your provider after your required out of pocket portion is satisfied. Member Pay: Choice will automatically issue payment via check or direct deposit to you after your required out of pocket portion is satisfied. Choice Strategies Card: If you do not have a Choice Strategies Card, it will be issued to you once your required out of pocket portion is satisfied. You can then use the card for any eligible expenses after that time up to the HRA limit.

8 The HRA Run Out Period What Is It? My Plans Run Out
A 3 month period of time when employees may still receive bills/statements from prior year services. Employees may submit manual claims for expenses during this time Claims must be submitted manually Do not use the Choice Strategies Card for prior year expenses with an HRA Plan Year 00/00/ /00/0000 Run Out Period

9 Flexible Spending Account (FSA) Plan Year: 00/00/0000-00/00/0000
Key Features Funding Eligible Expenses Employer Owned Less payroll taxes! Employee Funded Pre-tax contributions per pay period Prefunded Employees have access to funds from day 1 of the plan year IRS Contribution limit $2,600 pre-tax All IRS eligible medical expenses IRS Publication 502 WageWorks eligible expense list Doctor Office visits Hospital visits Copays & Coinsurance Prescriptions Some Over-the-Counter products Vision Dental And More!

10 The Grace Period What Is It? My Plans Grace Period
A 2 ½ month period of time that extends the plan year so that participants can use any remaining funds Choice Strategies Card can be used during this time For previous year expenses For expenses incurred during the Grace period Plan Year 00/00/ /00/0000 Grace Period

11 The FSA Carryover What Is It? Example
A provision for FSAs that allows up to $500 to carryover from year to year The carryover amount does not impact how much someone can contribute in the following year John had a previous year FSA for $2,500 He spent all but $500 The $500 carried over into his new FSA He choose to elect the full IRS maximum of $2,600 for his new FSA John now has a new FSA with a balance of $3,100

12 Dependent Care Account (DCA) Plan Year: 00/00/0000-00/00/0000
Key Features Funding Eligible Expenses Employer Owned Less payroll taxes! Employee Funded Pre-tax contributions per pay period Funds Accumulate Money can only be used as funded into the account IRS Contribution limit $5,000 pre-tax Married and filing jointly $2,500 pre-tax Married and filing separately All IRS eligible custodial care expenses WageWorks eligible expense list Babysitting (work related, not provided by tax dependent) Before or after school programs (primarily custodial) Custodial elder care Nanny Preschool Summer day camp Transportation to and from eligible dependent care

13 FSA Savings Examples Without FSA / DCA Gross Monthly Salary $2,500.00
Less: Federal Income Tax $333.61 State Income Tax $174.79 FICA Tax $191.25 Net Income $1,800.35 Health Care Expenses $200.00 Dependent Care $400.00 Spendable Income $1,200.35 With FSA/DCA Gross Monthly Salary $2,500.00 Less: Health Care Expenses $200.00 Dependent Care $400.00 Taxable Income $1,900.00 Federal Income Tax $253.54 State Income Tax $132.84 FICA Tax $145.35 Spendable Income $1,368.27 Monthly Savings $167.92 Annual Savings $2,015.04

14 The Choice Strategies Card
Key Features 1 card Even if there are multiple accounts Swipe as Credit vs. Debit Access to the PIN if needed, is on the “My Card” tab in the member online account Card activates upon first use for an eligible expense Within the available balance on the plan Spouses automatically receive their own card Dependent cards can be issued upon request, free of charge

15 Payment Example: Medical Deductible Expenses
Present health insurance carrier ID card Pay copay if applicable Complete visit with the healthcare provider Provider will submit information to health insurance carrier Carrier will make adjustments and issue an Explanation of Benefits (EOB) Provider will issue a detailed bill or statement Pay the bill using the Choice Strategies Card Provide the card number on the provider bill within the billing section

16 Payment Example: Prescription Expenses
Bring the prescription to pharmacy Pharmacist will advise of the prescription price Make sure that the pharmacy has your updated insurance/benefit information Pay the bill using the Choice Strategies Card Swipe the card as credit vs. debit for your convenience IIAS (Inventory Information Approval System) No Request for documentation on Rx charges if IIAS Approved Pharmacy is used. (List available on

17 Submitting a Claim Online Mobile App Paper
Instructional video available Processing time is about 1-3 business days Only 2 more days to receive reimbursement if signed up for direct deposit Instructional video available Take pictures of your supporting documentation and upload directly to transactions / claim submissions Fax: Mail: P.O. Box 2205, South Burlington, VT Member Forms Page

18 Documentation Requirements
No Response? The IRS states that supporting documentation must be supplied for card transactions used with tax advantaged benefits. Keeps a company’s plan in compliance Card will be placed in a temporarily inactive state until the transaction can be resolved Resolution occurs when appropriate documentation is sent or a refund is made to the account Your Responsibility Respond to documentation requests made by Choice Strategies Notices are sent via or mail. Always , if on file Multiple notices sent Appropriate documentation includes: Explanation of Benefits Detailed Provider's bill or statement

19 Online Account & Mobile Application
Training Video: cc/NewMemberPortalOvervie w Training Video: Features Available Balance Transaction History Upload Supporting Documents Card Status Update Personal Information Submit Claims Online

20 Phone: (Option 2)


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