Group NameEmployer ID: CHO

Plan Year: 01/01/2015-12/31/2015

Presented By: NameTitle

Instructions: Find and ReplaceDelete 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 NameHealth Insurance Carrier: CarrierPlan Year: 01/01/2015-12/31/2015Plan Start Date: 01/01/2015HRA 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 PlanCarrier

Deductible:• Single: $$$• Family: $$$$

Effective 01/01/2015, Choice Strategies will be administering:

• Health Reimbursement Arrangement (HRA)

• Flexible Spending Account (FSA)• Dependent Care Account (DCA)

Health Reimbursement ArrangementHRA

Group Name’s HRA Plan:

• Plan Year: 01/01/2015-12/31/2015

• BEFORE funds are available in the HRA for use, you must pay the following amount of Carrier deductible expenses out-of-pocket. This is called your HRA Deductible:– Single: $$$$$– Family: $$$$$$

• AFTER you pay the HRA deductible out-of-pocket, the HRA reimburses up to: – Single: $– Family: $$

Health Reimbursement ArrangementHRA

• To activate the account once HRA deductible has been satisfied:– Submit a claim and attach supporting documentation– Claims can be submitted through your online account

or claim forms are available under the “For Members” tab and “Forms” page on www.choice-strategies.com

• HRA-Eligible Expenses include:– Office Visits– Hospital– Prescriptions– Outpatient

Group Name’s HRA Plan:

End of Plan YearHealth 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: 01/01/2015-12/31/2015

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 12/31/15. You have until 3/31/2016 to submit manual claims for dates of service that occurred during the 2015 calendar plan year.

Flexible Spending AccountFSA

• Plan Year: 01/01/2015-12/31/2015

• Contributed through payroll deductions

• “Use it or Lose it”

• Eligible Expenses:

• Medical• Dental • Vision• Prescriptions• Limited Over-the-Counter (OTC) products

You can elect to contribute up to $2,550 pre-tax

End of Plan YearFlexible 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: 01/01/2015-12/31/2015

• 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 12/31/15. You have until 3/15/2016 to use remaining FSA funds for dates of service that occurred during the 2015 plan year and through the Grace Period.

End of Plan YearFlexible Spending Account

The FSA Carryover

Will the carryover amount effect the amount that can be elected pre-tax for the next plan year? No.

What is it? A provision for FSAs that allows up to $500 to carryover from year to year.

So, if the carryover is $500 from a previous year, the available balance for the new year could be anything up to $3,050? Yes.

Dependent Care AccountDCA

• Plan Year: 01/01/2015-12/31/2015

• 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

You can elect to contribute up to:• $2,500 if married, filing separate tax returns• $5,000 if single OR married, filing jointly

Employee SavingsExample

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 $2,015.04Based on 13.34% Federal Income Tax, 7%

State Income Tax, and 7.65% Social Security Tax Rate

Choice Strategies CardThe 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 CardMedical Providers

Present Your Health Insurance

ID Card.Complete

Visit

Provider Will Submit Claim To Health Insurance

Health Insurance adjusts claim and

generates Explanation of

Benefits

You will receive an EOB from your Health

Insurance and a doctors bill

Pay with your Choice Strategies

Card!

Do not pay on the date of service, wait until you receive the Explanation of Benefits from Carrier.

Using the CardPrescriptions

Doctor writes a Prescription (Rx) and gives to you.

Bring Rx to pharmacy.

(Make sure updated Carrier information

is on file)

Pharmacist advises price of

Rx.

Employee pays with Choice

Strategies Card!

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 ClaimNeed Reimbursement?

• Online – Faster Reimbursement! – Login to your Online Account– Select “Submit a Claim”– Fill our required fields– Upload Supporting documentation– Select “Submit”

• 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 RequirementsDocumentation 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 ServiceFree and Voluntary

Allows Choice Strategies to view your Explanation of Benefits from the online account with Carrier

Signing Up:

1) You must set up an online account with Carrier

2) 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 Accountswww.choice-strategies.com

Helpful Features! • Check available balance• Review transaction history • Upload supporting documentation• Verify the Choice Strategies Card status• Update personal information

• Email, home address, phone number• Submit claims online

• Reimbursement method

Video tutorial available

Mobile AppAccess Your Information on the Go!

Available For iOS and Android

Video tutorial available

You Can:• Create Account• Check available balance• Review transaction history• Submit claims• Upload supporting documentation

We are Here to Help!

Phone: 888-278-2555 (Option 2)

Hours: Monday-Friday 8:00am – 8:00pm EST