Presentation Transcript

1. Group Name Plan Year : 1/1/12-12/31/12
2. Find and Replace ( to be edited) Getting Started: Enrollment presentations can be shown to your employees to help explain how to use their Choice Strategies card in conjunction with their health insurance plan. Before distributing this handout to employees, please find and edit the following: Group Name : Group Name Health Insurance Carrier : Carrier Plan Year : 1/1/12-12/31/12 Plan Start Date : 1/1/12 HRA Single Deductible : $$$ HRA Family Deductible : $$$$ Carrier Single Deductible : $$$$$ Carrier Single Deductible : $$$$$$ FSA Maximum : $2500 Footer info here
3. New Health Plan Health Plan Deductible: Single : $$$$$ Family : $$$$$$ Effective 1/1/12, Choice Strategies will be administering: Employee Pay First Health Reimbursement Arrangement (HRA) Footer info here
4. Employee Pay First HRA Plan Group Name’sHRA plan Plan Year: 1/1/12 – 12/31/12 You must pay a portion out-of-pocket before you will have access to HRA funds: Single: $$$ Family: $$$$ AFTER you pay your out-of-pocket responsibility, you will be provided with: Single: $$$ Family: $$$$ 4
5. Employee Pay First HRA Plan Eligible medical expenses include any service that is applied to your deductible and including but not limited to: Office Visits Inpatient Outpatient Prescriptions
6. Employee Pay First HRA Plan To activate account funds once your share has been been met, complete an Employee Shared Responsibility Form and submit it to Choice Strategies. This form is available at: http://choice-strategies.com/forms-1 and should be submitted with supporting documentation for your out-of-pocket charges.
7. 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
8. Using Card for Medical Providers Before you meet your portion of the deductible: 1. When you visit a provider present them with your Carrier ID Card. 2. Carrier should be billed first. 3. Carrier then assigns the negotiated rates and applies the charges toward your deductible. 4. Carrier sends you an “Explanation of Benefits” (EOB) statement. Keep this statement to submit to Choice Strategies. 5. When billed by the provider, pay the bill using your own out- of-pocket funds. Bills can usually be paid by mail, phone or in person.
9. Using Card for Medical Providers After you meet your portion of the deductible: Reminders : Do Not Pay on the Date of Service, wait until you receive the EOB from your insurance company Always give your provider your Carrier ID card and ask your provider to submit to insurance
10. Using Card at Pharmacy Reminders : Check to make sure the pharmacy has your current insurance information Use as credit card
11. 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) 11
12. Substantiation Service Voluntary Service that allows Choice Strategies to view Employees’ Explanation of Benefits from their online accounts with their Carrier. Employees set-up online account with Carrier Employee fills out HIPAA Release form with User ID and Password When Employee uses Debit Card for a transaction, Choice Strategies logs in to Carrier Website and matches charge to Explanation of Benefits
13. 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 submitted manually through the claim process. Example: If the plan year ends 12/31/12, you have until 3/31/13 to submit manual claims for dates of service that occurred during your 2012 plan year. Do not charge your Choice Strategies card. If you charge your card, it will pull from current plan year funding. The IRS does not allow previous plan year expenses to be paid with current year funding. Footer info here 13
14. 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 : memberservices@choice-strategies.com Live Chat : www.choice-strategies.com Mon-Thurs 8:00 am – 4:45 pm EST Friday 9:00 am – 4:45 pm EST
15. Online Account Check Account Balances Submit Claims Online Edit Direct Deposit Info View Transaction History Upload Documentation Report Card Lost/Stolen
16. 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 16
17. Questions?