Section 125 (FSA) Participant Communications Guide

Transcription

1 Section 125 (FSA) Participant Communications Guide

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3 TABLE OF CONTENTS INTRODUCTION... 1 Additional Section 125 Resources Available... 1 Other Resources Available... 1 PARTICIPANT COMMUNICATIONS... 2 Enrollment Materials... 2 Enrollment Brochure... 2 Posters... 2 Flyers/ Payroll Stuffers... 2 These stuffers are used to advertise your plan... 2 More tools... 2 PARTICIPANT ACCOUNT INFORMATION... 3 Participant Account Correspondence... 3 Enrollment Confirmation... 3 Receipt Request Reminder Statement... 3 Participant Account Balance Reminder Notice... 3 Claim Process and Payments notification... 3 Claims Processed but not yet paid... 3 Reimbursement Check... 3 Direct Deposits... 3 Claim Follow-up Notice... 3 Flexible Benefits Card swipes... 4 Payment Card Transaction... 4 Payment Card Declines... 4 Flexible Benefits Card swipes... 4 Payment Card Transaction... 4 Other Account functions and information available... 4 ADMINISTRATIVE FORM DESCRIPTIONS... 6 Client Administrative Forms... 6 Enrollment Brochure... 6 Participant Forms... 6 Spending Account Claim Form... 6 Direct Deposit Authorization Form... 6 Change of Address Notification Form... 7 APPENDIX A PARTICIPANT COMMUNICATION... 8 APPENDIX B PARTICIPANT CORRESPONDENCE APPENDIX C ADMINISTRATIVE FORMS WageWorks, Inc. i

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5 INTRODUCTION This Section 125 Participant Communications Guide is designed to provide you with details on your Flexible Spending Account participant materials that are available for distribution. The following resources are also available to support the administrative and communication needs of your program administered by us. Additional Section 125 Resources Available Section 125 Administration Guide Provides details for on-going administration duties. Section 125 Client Communications and Reports Guide Provides details and examples of available client communications and reports. Data Submission Guide Provides details on the available methods of reporting data. Other Resources Available HIPAA Summary Guide Provides details on HIPAA compliance WageWorks, Inc. 1

6 PARTICIPANT COMMUNICATIONS (See Appendix A for examples of participant communications.) Enrollment Materials The following outline our take care program, proven to deliver clear consumer oriented information and to increase participation in the plan. Participant communication materials are always available on our website and are free of charge. Enrollment Brochure The take care Enrollment Brochure explains the Flexible Spending Account program, assists the employee in planning their participation, answers frequently asked questions and includes a tear off enrollment form. Everything they need to make their participation experience easy and positive. We have several brochure options to meet your needs. All are available in printed form as well as an pdf document. The tear off enrollment form gathers the necessary data to populate our administrative system. Take care Enrollment Brochure with Flexible Benefits Card Take care Enrollment Brochure with additional benefit options Take care Enrollment Brochure plus integrated HSA Account Take care Enrollment Brochure without card Posters The following posters are a great way to promote your plan. Save 25-40% on Family s Medicines Save 25-40% on Doctor s visits Save 25-40% on Day Care Save 25-40% on Expenses Your Health Plan Doesn t Pay Flyers/ Payroll Stuffers These stuffers are used to advertise your plan Save 25-40% on Expenses Your Health Plan Doesn t Pay Save 25-40% on non-prescription items More tools Mytakecareplan.com web site with savings calculator Employee video WageWorks, Inc. 2

7 PARTICIPANT ACCOUNT INFORMATION Our goal is to provide the information participants need when they need it. Consequently, there is a wealth of information available 24x7 on our secure participant web site. However, when correspondence is necessary, we use postal mail as the most reliable method of delivering information. Web site or access is not required to effectively participate in the plan. The various participant correspondences that we provide to participants are outlined below. Participant Account Correspondence Enrollment Confirmation Participants receive an enrollment confirmation via postal mail to let them know that their enrollment was received and updated in our system. See Appendix B.1. Receipt Request Reminder Statement Each month, participants receive a statement of the debit card swipes which we are requesting to verify their receipts. A statement is sent only if the participant has nay remaining card swipes for which additional receipts must be submitted. See Appendix B.2. Participant Account Balance Reminder Notice 60 days prior to the end of the plan year, each participant with a balance of more than $10 receives a letter reminding them to use their funds for qualified expenses before the plan year end date, including the applicable ending date for claims submission. See Appendix B.2.. Claim Process and Payments notification Claims Processed but not yet paid Claims processed but not paid are shown on the secure participant web site. Reimbursement Check Claims paid are shown on the secure participant web site. Direct Deposits Direct deposit payments are shown on the secure participant web site. Claim Follow-up Notice WageWorks, Inc. 3

8 The participant receives a letter detailing the reasons for any submitted claim amount which was denied. Flexible Benefits Card swipes Payment Card Transaction When a participant uses their payment card, the transaction is immediately shown on the secure participant web site. Payment Card Declines If a participant attempts to use their payment card and is declined, the transaction is immediately available on the secure participant web site along with the specific reason for the decline. Flexible Benefits Card swipes Payment Card Transaction When a participant uses their payment card, the transaction is immediately shown on the secure participant web site. Other Account functions and information available Account Balance Account balance and summary information is shown on the landing page of the secure participant web site. The most frequently asked question is also the quickest to answer. The information is also available via the phone from our Interactive Voice Response (IVR) system 24x7. Request a payment The participant can create a claim online to request payment at the secure participant web site, print and fax/mail/ the claim along with supporting receipts/documentation. Of course, they can also submit a paper claim form. Request extra cards The participant can request additional cards at the secure participant web site. There is no charge for extra cards. Pending payments Claims or swipes in process are shown on the secure participant web site Completed payments WageWorks, Inc. 4

9 All completed payments (claims or card swipes) are shown on the secure participant web site. Review card payments All card swipes which we are asking for receipts are shown on the secure participant web site. The participant can also create the receipt verification form online, for easy submission of receipts for verification. Repay non-qualified expenses online If the participant swipes the card and receipts are required, but they don t have them, they must repay the plan. This repayment can be accomplished on the secure participant web site with standard credit card payment WageWorks, Inc. 5

10 ADMINISTRATIVE FORM DESCRIPTIONS Included in this Guide are several forms with which you will need to be familiar. They are described here for your reference and are readily available on our secure employer website. Client Administrative Forms Administrative forms are those that you, the Plan Administrator, will use to gather information from your employees and then transmit to us. Enrollment Brochure The Enrollment Brochure/ form is used to manually notify us of participants who will be making a new election. Terminating or changing a participant s information can also be done by by entering the change online on the secure employer web site or by sending us a data file. Participant Forms The following are forms that may be completed by the participant during the plan year. Spending Account Claim Form Each expense that is submitted to the Spending Account for reimbursement must be substantiated by documentation. The IRS requires 100% substantiation of each expense, even when the payment card is used to pay for the expense. The participant can directly enter their claim online through a web claim entry screen, print their claim form and fax along with his receipts or substantiation to us for final adjudication. Substantiation is defined as receipts (canceled checks, check carbons or balance forward statements are not acceptable) or Explanation of Benefit statements submitted with the claim form, which must show date(s) of service, description of service or product purchased, who incurred the expense and the amount of the service or product. The claim form must be signed by the participant and can be faxed, mailed or ed directly to us for claim adjudication. We prefer participants to or fax their claims to us at We scan all claims and receipts so if a participant sends a claim via US mail, we ask that small receipts such as prescription receipts, be taped to an 8 ½ x 11 piece of white paper to assist in scanning the receipts quickly. If an employee drops his claims off to you, be aware that the claim may contain private health information (PHI) and encourage the employee to send the claim directly to us. That helps take the administrative burden off you, as well as, comply with HIPAA regulations. Direct Deposit Authorization Form A direct deposit form is included with each paper check to encourage your employees to participate and get the many advantages offered by direct deposit. The participant can forward this form directly to us and have their next claim reimbursement directly deposited into their checking account WageWorks, Inc. 6

11 Change of Address Notification Form If you are advised of an address change for a Spending Account participant, be sure to forward the new address to us, or better yet, enter it online at the secure employer web site. In addition, a participant has the opportunity to up date their new address on the secure participant web site and you will be notified via to confirm. You, as the employer, can also forward the address changes via your electronic file submission or enter the change online at the secure employer website WageWorks, Inc. 7

12 APPENDIX A PARTICIPANT COMMUNICATION WageWorks, Inc. 8

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16 APPENDIX B PARTICIPANT CORRESPONDENCE WageWorks, Inc. 12

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19 APPENDIX C ADMINISTRATIVE FORMS WageWorks, Inc. 15

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