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Group Name Plan Year: 00/00/0000-00/00/0000. Presented By: Your Name Here Your Title Here. Instructions: Find and Replace Delete This Slide Before Presenting. Getting Started: Enrollment p resentations can be shown to employees to help explain how to use their Choice Strategies plan.
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Group Name Plan Year: 00/00/0000-00/00/0000 Presented By: Your Name Here Your Title Here
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: 01/01/2013-12/31/2013 • Plan Start Date: 01/01/2013 • HRA Single Out-of-Pocket Responsibility: $$$$$ • HRA Family Out-of-Pocket Responsibility: $$$$$$ • HRA Single Funding: $ • HRA Family Funding: $$ • Carrier Single Deductible: $$$ • Carrier Family Deductible: $$$$ • FSA Maximum: $2,500
Your Health Plan Carrier Deductible: • Single: $$$ • Family: $$$$ Effective 01/01/2013, Choice Strategies will be administering: • Health Reimbursement Arrangement (HRA) • Flexible Spending Account (FSA) • Dependent Care Account (DCA)
Health Reimbursement Arrangement HRA Group Name’s HRA Plan: • Plan Year: 01/01/2013-12/31/2013 • BEFORE funds are available in the HRA for use, You must pay a portion out-of-pocket: • Single: $$$$$ • Family: $$$$$$ • AFTER you pay your out-of-pocket responsibility, The HRA reimburses up to: • Single: $ • Family: $$
Health Reimbursement Arrangement HRA - Continued Group Name’s HRA Plan: • Eligible Expenses that apply to your Carrier deductible: • Office Visits • Hospital • Prescriptions • Outpatient • To activate the account once out-of-pocket portion has been satisfied: • Complete Employee Shared Responsibility Form and attach supporting documentation • Available under the “For Members” tab and “Forms” page on www.choice-strategies.com
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: 01/01/2013-12/31/2013 • 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 12/31/13. You have until 3/31/2014 to submit manual claims for dates of service that occurred during the 2013 calendar plan year.
Flexible Spending Account FSA You can elect to contribute up to $2,500 pre-tax • Plan Year: 01/01/2013-12/31/2013 • Contributed through payroll deductions • “Use it or Lose it” • Eligible Expenses: • 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: 01/01/2013-12/31/2013 • 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 12/31/13. You have until 3/15/2014 to use remaining FSA funds for dates of service that occurred during the 2013 plan year and through the Grace Period.
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: 01/01/2013-12/31/2013 • 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
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 You will receive an EOB from your Health Insurance and a doctors bill Health Insurance adjusts claim and generates Explanation of Benefits Present Your Health Insurance ID Card. Provider Will Submit Claim To Health Insurance Pay with your Choice Strategies Card! Complete Visit Do not pay on the date of service, wait until you receive the Explanation of Benefits from Carrier.
Using the Card Prescriptions Employee pays with Choice Strategies Card! Bring Rx to pharmacy. (Make sure updated Carrier information is on file) Doctor writes a Prescription (Rx) and gives to you. Pharmacist advises price of Rx. • 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! • 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.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 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: • You must set up an online account with Carrier • 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 • Check Account Balances • View Transaction History • Upload Supporting Documentation • Report Cards Lost/Stolen • Request reissue too! • Submit Claims Online • Faster Reimbursement • Edit Personal Information • Phone Number • Email Address • Direct Deposit • Mailing Address
Mobile App Access Your Information on the Go! • Available For: • iOS Apple • Android • You Can: • View account balances • View recent transactions • Submit claims • Upload supporting documentation
Contact Us! Member Services is Here to Help You! Phone: 1-888-278-2555 (Option 2) Monday-Friday 8:00 am – 8:00 pm (EST) Email: memberservices@choice-strategies.com