Group Name Plan Year : 1/1/12-12/31/12. Find and Replace (Delete Slide before Presenting) Getting Started: Enrollment presentations can be shown to employees.

Group NamePlan Year : 1/1/12-12/31/12

Find and Replace (Delete Slide before Presenting)

Getting Started: Enrollment presentations can be shown to employees to help explain how to use their Choice Strategies Plan in conjunction with their health insurance 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 : 1/1/12-12/31/12• Plan Start Date : 1/1/11• HRA Single Deductible : $$$• HRA Family Deductible : $$$$• Carrier Single Deductible : $$$$$• Carrier Single Deductible : $$$$$$• FSA Maximum : $2500

Carrier Health Plan

• Carrier Health Plan Deductible:– Single : $$$$$– Family : $$$$$$

• Effective 1/1/12, 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: 1/1/12 – 12/31/12• The HRA reimburses up to:

– Single: $$$– Family: $$$$

• This money can be used for any expenses that apply to your Carrier Deductible:– Office Visits– Hospital– Prescriptions– Outpatient, etc

Flexible Spending Account (FSA)

• You can elect up to $2500• Plan Year: 1/1/12 – 12/31/12• Pre-tax money, contributed through payroll

deductions• “Use it or Lose it”• Eligible expenses:

– Medical & Rx expenses– Dental Expenses– Vision Expenses– Limited OTC

Dependent Care Account (DCA)

• You can elect up to $5000 • Plan Year: 1/1/12 – 12/31/12

• Pre-tax money, contributed

through payroll deductions• Pay as you go, can only spend

what you have contributed• “Use it or Lose it”• Eligible Expenses : Custodial Care of dependents while

employee is at work

Employee Savings Example

Without FSA/DCA Gross Monthly Salary $2,500.00 Less:   Federal Income Tax $333.61 State Income Tax $174.79 Social Security Tax $191.25 Net Income $1,800.35 Less:   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 Less:   Federal Income Tax $253.54 State Income Tax $132.84 Social Security Tax $145.35 Spendable Income $1,368.27 Monthly Savings $167.92 Annual Savings $2,015.04

Based on 13.34% Federal Income Tax, 7% State Income Tax, and 7.65% Social Security Tax Rate

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 to

Member Services

Using Card for Medical Providers

Reminders :• Do Not Pay on the Date of Service, wait until you

receive the Explanation of Benefits (EOB) from your insurance company

• Always give your provider your Carrier ID card and ask your provider to submit to insurance

Using Card at Pharmacy

Reminders :• Check to make sure the pharmacy has your current

insurance information• Use as credit card

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)

Substantiation Service

• Voluntary Service that allows Choice Strategies to view Employees’ Explanation of Benefits from online accounts with their Carrier.

1. First, Employees must set-up online account with Carrier

2. Employee fills out HIPAA Release form with User ID and Password

3. When Employee uses Debit Card for a transaction, Choice Strategies logs in to Carrier Website and matches charge to EOB

HIPAA RELEASE FORM

Available on Websitewww.choice-strategies.com

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 be submitted manually through the claim process.

• Example: If the plan year ends 12/31/11, you have until 3/31/12 to submit manual claims for dates of service that occurred during your 2011 plan year. Do not charge your Choice Strategies card. If card is charged in 1/12, the transaction will pull from current plan year, 2012, funding. The IRS does not allow previous plan year expenses to be paid with current year funding.

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 : [email protected]• Live Chat : www.choice-strategies.com

– Mon-Thurs 8:00 am – 4:45 pm EST– Friday 9:00 am – 4:45 pm EST

Check out the Website

www.choice-strategies.com

Online Account

• Check Account Balances• Submit Claims Online• Edit Direct Deposit Info

• View Transaction History• Upload Documentation• Report Card Lost/Stolen

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

Questions?