Group NamePlan Year : 1/1/11-12/31/11

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Find and Replace ( to be edited)

Getting Started: Enrollment presentations can be shown to your employees to help explain how to use their Choice Strategies card in conjunction with their health insurance plan. Before distributing this handout to employees, please find and edit the following:

• Group Name : Group Name• Health Insurance Carrier : Carrier• Plan Year : 1/1/11-12/31/11• Plan Start Date : 1/1/11• HRA Single Deductible : $$$• HRA Family Deductible : $$$$• Carrier Single Deductible : $$$$$• Carrier Single Deductible : $$$$$$• FSA Maximum : $2500

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New Health Plan

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

• Effective 1/1/11, Choice Strategies will be administering:– Health Reimbursement Arrangement (HRA) – Flexible Spending Account (FSA)– Dependent Care Account (DCA)

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Health Reimbursement Arrangement (HRA)

Group Name’s HRA plan

• Plan Year: 1/1/11 – 12/31/11• 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

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Flexible Spending Account (FSA)

• You can elect up to $2500• Plan Year: 1/1/11 – 12/31/11• Pre-tax money, contributed through payroll

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

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

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Dependent Care Account (DCA)

• You can elect up to:– $2500 if single, or married filing separately– $5000 if married filing jointly

• Plan Year: 1/1/11 – 12/31/11• 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

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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

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Payment to Medical Providers

Reminders :• Do Not Pay on the Date of Service, you will receive

the EOB from your insurance company.• Always give your provider your Carrier ID card and

ask your provider to submit to insurance.

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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.

• Choice Strategies has partnered with Carrier to receive a weekly data-feed of medical and Rx claim data for all of our members enrolled on a Carrier health plan. Essentially, the data-feed provides Choice Strategies with all of the information found on our members’ Explanation of Benefits (EOB) Statements.

• 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)

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End of Plan Year

Plan Year: 1/1/11-12/31/11

• 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.

• 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.

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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 : memberservices@choice-strategies.com• Live Chat : www.choice-strategies.com

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

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Online Account

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

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

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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

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Questions?