Group Name
Employer ID: CHO
Plan Year: 01/01/2016-12/31/2016
Presented By: Name
Title
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: 01/01/2016-12/31/2016
Plan Start Date: 01/01/2016
HRA Single Out-of-Pocket Responsibility: $$$$$
HRA Family Out-of-Pocket Responsibility: $$$$$$
HRA Single Funding: $
HRA Family Funding: $$
Carrier Single Deductible: $$$
Carrier Family Deductible: $$$$
FSA Maximum: $2,550
Your Health Plan
Carrier
Deductible:
• Single: $$$
• Family: $$$$
Effective 01/01/2016, Choice
Strategies will be
administering:
• Health Reimbursement Arrangement
(HRA)
• Flexible Spending Account (FSA)
• Dependent Care Account (DCA)
Health Reimbursement Arrangement (HRA)
Plan Year: 01/01/2016-12/31/2016
Key Features
• Employer-funded
 Funds used are tax
deductible to
employer
 Tax free to the
employee
• Implementation in
combination with
High Deductible
Health Plan helps to
lower costs
Funding
• BEFORE funds are
available in the HRA for
use, you must pay the
following deductible
expenses out-ofpocket.
 Single: $$$$$
 Family: $$$$$$
• AFTER you pay the
HRA deductible out-ofpocket, the HRA
reimburses up to:
 Single: $$$$$
 Family: $$$$$$
Eligible Expenses
• Medical Deductible
 Co-pay
 Coinsurance
• Prescriptions
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
What supporting documentation should I send?
Explanation of Benefits (EOB)
Provider Bill or Statement
• Statement from your health
insurance company detailing your
responsibility as the patient
(deductible) and the insurance
adjustments made.
• 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.
When will the HRA funds become available?
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.
The HRA Run Out Period
What Is It?
• 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
My Plans Run Out
• Plan Year
 01/01/2016-12/31/2016
• Run Out Period
 01/01/2017-03/31/2017
Flexible Spending Account (FSA)
Plan Year: 01/01/2016-12/31/2016
Key Features
• Employer-owned
 Reduced payroll taxes!
• Employee-funded
 Pre-tax contributions
per pay period
• Prefunded
 Employees have access
to funds from day 1 of
the plan year
Funding
• IRS Contribution limit
 $2,550 pre-tax
Eligible Expenses
• 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!
The FSA Grace Period
What Is It?
• 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
My Plans Run Out
• Plan Year
 01/01/2016-12/31/2016
• Grace Period
 01/01/2017-03/15/2017
The FSA Carryover
What Is It?
Example
• A provision for FSAs that allows
up to $500 to carry over from
year to year
• John had a previous year FSA for $2,500.
• The carryover amount does not
impact how much someone can
contribute in the following year
• The $500 carried over into his new FSA.
• He spent all but $500.
• He choose to elect the full IRS maximum
of $2,550 for his new FSA.
• John now has a new FSA with a balance
of $3,050.
Dependent Care Account (DCA)
Plan Year: 01/01/2016-12/31/2016
Key Features
• Employer-owned
 Reduced payroll taxes!
• Employee-funded
 Pre-tax contributions
per pay period
• Funds Accumulate
 Funds become
available after they are
deposited into the
account
Funding
Eligible Expenses
• IRS Contribution limit
• All IRS eligible custodial
care expenses
 $5,000 pre-tax
+ Married and filing jointly
 $2,500 pre-tax
+ Married and filing
separately
 WageWorks eligible
expense list
+ Babysitting (work-related,
not provided by your
dependent)
+ Before or after school
programs (primarily
custodial)
+ Custodial elder care
+ Nanny
+ Preschool
+ Summer day camp
+ Transportation to and from
eligible dependent care
Employee Savings
Example
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
Less:
Health Care Expenses
$200.00
Dependent Care
$400.00
Spendable Income
$1,200.35
Based on 13.34% Federal Income Tax, 7%
State Income Tax, and 7.65% FICA
With FSA/DCA
Gross Monthly Salary
Less:
Health Care Expenses
Dependent Care
Taxable Income
Less:
Federal Income Tax
State Income Tax
FICA Tax
Spendable Income
Monthly Savings
Annual Savings
$2,500.00
$200.00
$400.00
$1,900.00
$253.54
$132.84
$145.35
$1,368.27
$167.92
$2,015.04
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
 Additional dependent cards are issued upon request, free of charge
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
Do not pay on the date of service. Wait until you receive the
Explanation of Benefits from Carrier.
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 (instead of 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 www.choice-strategies.com)
Submitting a Claim
Online
• Instructional video
available
 Processing time is
about 1-3 business
days
 Only 2 more days to
receive reimbursement
if signed up for direct
deposit
Mobile App
• Instructional video
available
 Take pictures of your
supporting
documentation and
upload directly to
transactions / claim
submissions
Paper
• Fax: 1-877-723-0148
• Mail: P.O. Box 2205,
South Burlington, VT
05407
Documentation Requirements
Requirement
• The IRS states that supporting documentation must be
supplied for card transactions related to Group Name plans.
 Keeps a company’s plan in compliance
Your Responsibility
• Respond to documentation requests made by Choice Strategies
 Notices are sent via email or mail.
+ Always email, if on file
+ Multiple notices sent
• Appropriate documentation includes:
 Explanation of Benefits
 Detailed providers bill or statement
No Response?
• 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
Online Account & Mobile Application
Online Account
• Training Video:
 https://www.brainshark.com/c
cc/NewMemberPortalOvervie
w
Mobile App
• Training Video:
 https://www.brainshark.com/ccc/CSMobileApp
Features
• Available Balance
• Card Status
• Transaction History
• Update Personal Information
• Upload Supporting Documents
• Submit Claims Online
We are Here to Help!
Phone: 888-278-2555 (Option 2)
Hours: Monday-Friday
8:00am – 8:00pm EST