Health Reimbursement Account How to Use Your Benny
Health Reimbursement Account How to Use Your Benny Card 1 IBEW-NECA Benefits Administration Association - Proprietary
What is a Health Reimbursement Account (HRA)? A health reimbursement account is an employer-funded plan. Contributions are directed from the employee’s salary to the HRA account. Because these contributions are not actually received by the employee, these contributions are not considered as wages for federal income tax purposes. These HRA contributions are tax-free. The funds in the HRA account can be used only for eligible medical care expenses, either through reimbursement or through Benny Card transactions. If the Benny Card is used to pay for an ineligible expense, then the amount of the transaction must be paid back to your HRA account, or the transaction amount must be reported as income on a 1099 -MISC. 2 IBEW-NECA Benefits Administration Association - Proprietary
Valid Merchants Note: this does not automatically verify that the transaction is for an HRA-eligible expense No! 3 IBEW-NECA Benefits Administration Association - Proprietary
Use the Benny Card for HRA-eligible expenses See page 59 of the SPD booklet, as well as on the HRA Participant Portal/Mobile App • The HRA claim is for an HRA-eligible expense • The HRA claim has not been previously reimbursed • The HRA claim is not a duplicate of a claim which has already been submitted/reimbursed • The HRA claim has processed through all applicable insurance • The HRA claim is filed in a timely manner • You must have the funds available in your HRA account to cover the debit transaction IBEW-NECA Benefits Administration Association - Proprietary 4
Make a payment with your Benny Card ü Already processed by all applicable insurance ü Has not previously been reimbursed/paid ü Enough Funds 5 IBEW-NECA Benefits Administration Association - Proprietary
Did you pay for a prescription at the pharmacy? Did you pay online at CVS Caremark? ü You are done. In most cases, documentation is NOT required Just in Case Save your pharmacy tag and receipt IBEW-NECA Benefits Administration Association - Proprietary 6
Did you pay a co-pay at the doctor’s office? ü You are done. In most cases, documentation is NOT required CO-PAY = $15 ALLOWED CO-PAYS: up to 5 times co-pay amount Just in Case Save your office visit receipt and any itemized statements or EOBs related to this visit IBEW-NECA Benefits Administration Association - Proprietary 7
Did you pay a previously approved amount? ü You are done. In most cases, documentation is NOT required Recurring Expense: if we have previously approved (with documentation) the exact payment amount to the same provider (per member), the transaction will be automatically substantiated Just in Case Save your documentation related to this transaction IBEW-NECA Benefits Administration Association - Proprietary 8
Allowed by IRS Regulation Prescriptions, Co-Pays, and Recurring Expenses can be automatically validated by our system Per IRS Bulletin 2007 -39 PLEASE NOTE Ø We do not manually validate these Benny Card transactions. Ø You are responsible for following the terms and conditions for use of the Benny Card. Just in Case Save your documentation IBEW-NECA Benefits Administration Association - Proprietary 9
NECA-IBEW Matched Claims Why do you have to send back the EOB that we sent to you? • Per IRS regulations, you must supply supporting documentation for HRA claims that are not auto-substantiated or for which you are requesting reimbursement • It is not efficient use of the fund’s time to search for documentation for your HRA claim • Member responsibility: by providing the EOB(s), you are validating that these are the charges that apply to your Benny Card transaction/reimbursement request. • Note: An itemized statement, billing statement, or receipt from the provider can be used for supporting documentation in place of EOBs. Just in Case Save your documentation IBEW-NECA Benefits Administration Association - Proprietary 10
NECA-IBEW Matched Claims BUT…. what we can do for you… After you use your Benny Card, we will try to match that transaction to a claim in our system. We will try to do that for 30 days. How will we match it? Benny Card Transaction Amount in our HRA system Patient Liability of one of your claims in our main system $129. 32 Just in Case Save your documentation IBEW-NECA Benefits Administration Association - Proprietary 11
NECA-IBEW Matched Claims Pay this amount to the provider. We will match it to the patient liability of a claim in our main system ü No Letter Sent ü No documentation required Just in Case Save your documentation IBEW-NECA Benefits Administration Association - Proprietary 12
Why Did I Get a Documentation Request Letter Ø The Benny Card charge was not for a prescription Ø The Benny Card charge was not for a co-pay Ø The Benny Card charge was not for a previously-approved amount Ø The Benny Card charge did not match the patient liability of one of your claims in our main system Ø It’s been 30 days since your Benny Card transaction 30 days after first letter Overdue Notice 30 days after Overdue Notice Suspension Notice, card is suspended Just in Case Save your documentation IBEW-NECA Benefits Administration Association - Proprietary 13
What Documentation Do I Need to Send? ØPaid Receipt from the Provider ØBilling Statement from the Provider ØEOB(s) ØItemized Statement from the Provider Ø If you have other insurance/Coordination of Benefits Ø Itemized Statement from the Provider or an EOB from other insurance Ø If we do not have your dependents in our system and the claim is for them, will need marriage certificate, birth certificate, etc. as applicable Just in Case Save your documentation IBEW-NECA Benefits Administration Association - Proprietary 14
How to Submit Documentation Ø Mail to Fund Office – attn: HRA Ø Fax to Fund Office – attn: HRA Ø Upload on HRA Participant Portal* Ø Upload on Mobile App* * Preferred Methods – having documentation attached to claim in the system will prevent suspension of card due to missing documentation IBEW-NECA Benefits Administration Association - Proprietary 15
Mobile App Before you can login to the mobile app, you must set up your account on the HRA Participant Portal at https: //necaibew. lh 1 ondemand. com. For instructions on setting up your account, please refer to this document in the Documents and Forms Library: After your account is set up, download the mobile app from the i. Tunes store (for i. Phone users) or Google Play (for Android users). Use ‘NECA IBEW HRA Benefits’ as the search term. The mobile app icon looks like this: Just in Case Save your documentation IBEW-NECA Benefits Administration Association - Proprietary 16
Mobile App After you download the mobile app, you can login using the username and password created on the HRA Participant Portal. After you log in successfully, you will be prompted to create a 4 -digit PIN code. This will be your login for the mobile app. You will be asked to enter it twice. You can also choose to enable Fingerprint Login by clicking on ENABLE TOUCH ID. IBEW-NECA Benefits Administration Association - Proprietary 17
Mobile App This is the home screen. You can: § View your Account Activity under My Accounts § File a Claim § Eligible Expense Scanner - NEW § View Account Snapshot Note: If you used your Benny Card to pay a bill, you do NOT need to file a claim! There is no ‘I Want To submit a receipt for a debit card transaction’. Instead, you will see an Alert in the Messages at the bottom of your screen. This indicates that the debit card transaction claim has been created and is ready for you to upload a receipt. (this may take a few days after you use the card). Also, the terms ‘receipt’ and ‘supporting documentation’ are used interchangeably. A receipt does not necessarily mean just a payment receipt; it could refer to an EOB or an itemized statement from the provider. 18 IBEW-NECA Benefits Administration Association - Proprietary
Mobile App Your claim that was created by using your Benny Card is highlighted in blue and is titled Claim Submission. Click the arrow on the Claim Submission line to access the claim information and to upload receipts. Note: on an Android device, this line item may have a different font color rather than an arrow. Just in Case Save your documentation IBEW-NECA Benefits Administration Association - Proprietary 19
Mobile App Your claim will be displayed. Click on New Receipt to upload a receipt (also called supporting documentation). When you click on New Receipt, the mobile app will access your device’s camera function, which will then allow you to simply take a picture of your receipts. You can also access your camera roll to select a photo. 20 IBEW-NECA Benefits Administration Association - Proprietary
Why Is My Benny Card Suspended? Ø Documentation is required, but was not received Ø Documentation was received, and after review by the HRA Department, the expense was determined to be ineligible for HRA. The ineligible amount must be repaid back to the HRA account. 21 IBEW-NECA Benefits Administration Association - Proprietary
What do I need to do to unsuspend my card? Ø Send in documentation Ø Use preferred methods of Mobile App/Consumer Portal upload Ø Submit a claim for reimbursement Ø Instead of sending you a reimbursement check, we will apply the reimbursement to the repayment amount. Ø Repay your HRA account Ø Send check to NECA-IBEW Welfare Trust Fund Ø Note ‘HRA Repayment’ on memo line Ø Do none of the above Ø You will receive a 1099 -M 22 IBEW-NECA Benefits Administration Association - Proprietary
Save all of your documentation! From the Provider ü ü ü From NECA-IBEW Pharmacy Tags Pharmacy Receipts Doctor Visit Notes Doctor Visit Bills Itemized Statements Hospital Bills ü Documentation Requests ü Emails ü Explanation of Benefits (EOBs) 23 IBEW-NECA Benefits Administration Association - Proprietary
What’s New? Ø Automatic reimbursement of Retiree Premiums – offered as a service by NECA-IBEW Ø Complete an authorization form Ø NECA-IBEW will reimburse you from your HRA account as funds allow – you will NOT need to file a claim for reimbursement each month Ø Three methods of auto-substantiation (reduces need for documentation) Ø Prescriptions, Co-pays, Recurring Expenses Ø Revised processing procedures for your HRA claims which should simplify and expedite the claim review process. Ø Fingerprint Login on both i. Phone and mobile devices. Ø Eligible Expense Scanner: scan barcodes to see if HRA-eligible. Has terms and conditions to agree to. Limited to 100 scans per month per member. IBEW-NECA Benefits Administration Association - Proprietary 24
Visit www. neca-ibew. org for More Information! Click here to see HRA information IBEW-NECA Benefits Administration Association Proprietary 25
- Slides: 25