State of Wisconsin Employee Reimbursement Accounts (ERA) 101

Transcription

1 State of Wisconsin Employee Reimbursement Accounts (ERA)

2 Agenda General Information Types of Accounts Account Overview Contribution Limits Qualified Dependents Eligible/Ineligible Expenses Enrollment Reimbursement TASC Card TASC Card Substantiation Qualifying Events/mid year changes Termination/Retirement TASC Online Account TASC Mobile App Forms TASC Resources/Customer Care

3 General Information Employee Reimbursement Accounts (ERA) program Optional benefit established for eligible state employees Commonly referred to as Flex Spending Accounts or FSAs Use pretax money to pay for eligible expenses IRS authorized under Sections 125, 105 and 129 Wisconsin Statutes ERA Enrollment Eligibility Eligible State and University employees Full-time or part-time classified Full-time or part-time unclassified Ineligible State and University employees Fellows, scholars, and research assistants in the University of Wisconsin System Limited term employees Student hourlies Per diems Temporary employees

4 Benefits of ERA Program Benefits of ERA program State of Wisconsin Tax Savings Save on employer taxes Used to help offset the costs of administration Additional benefits help retain and attract employees Participants Tax savings Save up to 30% on eligible expenses More money in their pockets Easy access funds Employer Tax Savings Example Health Care FSA Annual Contributions (10,000 employees contribute $1,500 annually) Dependent Day Care Annual Contributions (3,000 employees contribute $3,000 annually) $15,000,000 $9,000,000 Total FSA Contributions $24,000,000 Employer Savings* $1,836,000 *Based on FICA savings of 7.65% For illustration only. Actual results may vary.

5 Types of Accounts The Employee Reimbursement Accounts (ERA) program has five pretax benefit account options: Health Care Flex Spending Account Limited Purpose Health Care Flex Spending Account Dependent Day Care Flex Spending Account Parking Account Transit Account

6 Account Overview 2016 Plan Year Dates 2016 Contribution Limits Health Care FSA January 1 December 31, 2016 Limited Purpose FSA January 1 December 31, 2016 Dependent Day Care FSA January 1 December 31, 2016 Parking Account January 1 December 31, 2016 Transit Account January 1 December 31, 2016 $2,550 $2,550 $5,000 $255/month $130/month* Run Out End Date March 31, 2017 March 31, 2017 March 31, 2017 March 31, 2017 March 31, 2017 Carryover Option Allowed Eligible Expenses Yes, up to $500 Yes, up to $500 No Yes, no Carryover limit Medical, dental, vision out of pocket Dental, vision and post deductible medical out of pocket Day care expenses for eligible dependent (s) Parking expenses COBRA eligible Yes Yes No No No Yes, no Carryover limit Mass Transit expenses Mid year changes allowed Yes, requires a qualifying event Yes, requires a qualifying event Yes, requires a qualifying event Yes, at anytime Yes, at anytime *Note: Contributions of $130 is pre-tax State and Federal. Employees may contribute up to $255 however, contributions over $130 up to $255 would be pre-tax Federal and post-tax State.

7 Health Care Flex Spending Account Contribution Limits/Availability No minimum contribution Max contribution: $2,550/year If your spouse is eligible, both can enroll separately up to the IRS maximum Full election amount is available first day of plan start or coverage period Election amount will be divided out equally based on employees payroll schedule throughout the year Qualified Dependents spouse qualifying child qualifying relative Qualifying Child: eligible through the end of the calendar year in which they turn 26 Divorce: eligible child of divorced parents is a dependent of both, only 1 can submit expense for reimbursement Domestic Partner: expenses incurred by domestic partners would not be eligible since they are not considered spouses for federal tax purposes.

8 Health Care Flex Spending Account Eligible Expenses Co-pays and deductibles Medical office visits Prescription drugs Dental/orthodontia care Vision care Vaccinations Smoking cessation programs Mileage to-from doctor appointments Ineligible Expenses Insurance premiums Cosmetic procedures Personal hygiene products Vitamins/supplements Diet products/food Health club fees For a complete list of eligible expenses, visit the irs.gov website

9 Health Care Flex Spending Account Over-the-Counter (OTC) Medicine and Drugs Requires a prescription TASC Card cannot be used to purchase Examples of OTC Medicine and Drugs Pain relievers (Aspirin, Tylenol, Advil) Cold medicines Sinus medicines Indigestion or anti-acid relievers Teething gel Diaper rash ointment

10 Health Care Flex Spending Account Letter of Medical Necessity Required to prove that an expense is deemed medically necessary by a physician to treat a diagnosed medical condition TASC Card cannot be used to purchase Letter of Medical Necessity should include: Medical necessity of the expense, Diagnosed condition, Onset of condition, and Signed by the physician Examples of items that require a Letter of Medical Necessity Ear plugs Massage treatments Oxygen and oxygen equipment Support hose Varicose vein treatment Vitamins and supplements For more information, please reference the Letter of Medical Necessity available on the TASC online account and in the Participant Guide.

11 Health Care Flex Spending Account Orthodontia Expenses Two options for submitting expenses Scheduled Contract/service agreement with orthodontic provider Employee makes scheduled payments during treatment TASC Reimbursement: Employee receives scheduled FSA reimbursements Reimbursements can be over multiple FSA plan years Prepayment Full payment required before service begins TASC Reimbursement: Full payment is eligible for reimbursement date service begins Full payment reimbursement from current plan year up to FSA balance For more information on Orthodontia expenses, please reference the Orthodontia Worksheet available on the TASC online account and in the Participant Guide.

12 Limited Purpose Health Care Flex Spending Account ELIGIBILITY: Only available for employees enrolled in an HDHP/HSA Contribution Limits/Availability No minimum contribution Max contribution: $2,550/year If your spouse is eligible, both can enroll separately up to the IRS maximum. Full election amount is available first day of plan start or coverage period Election amount will be divided out equally based on employees payroll schedule throughout the year Qualified Dependents spouse qualifying child qualifying relative Qualifying Child: eligible through the end of the calendar year in which they turn 26 Divorce: eligible child of divorced parents is a dependent of both, only 1 can submit expense for reimbursement Domestic Partner: expenses incurred by domestic partners would not be eligible since they are not considered spouses for federal tax purposes.

13 Limited Purpose Health Care Flex Spending Account Eligible Expenses Dental/orthodontia care Vision care Post deductible medical expenses Mileage to-from dental/vision appointments Ineligible Expenses Medical expenses Insurance premiums Cosmetic procedures Personal hygiene products Vitamins/supplements Diet products/food Health club fees For a complete list of eligible expenses, visit the irs.gov website

14 Dependent Day Care Flex Spending Account Contribution Limits/Availability No minimum contribution Max contribution: $5,000/year If married file taxes jointly, $2,500/year for each person Election amount is available as payroll contributions are received Election amount will be divided out equally based on employees payroll schedule throughout the year Qualified Dependents A dependent under age 13 when the care occurred and for whom you can claim an exemption A spouse/dependent who is physically or mentally unable to care for him/herself Special rules for Divorced or separated parents Even if you cannot claim your child as a dependent, his/her expenses are eligible if all of the following are true: The child was under age 13 or was physically or mentally unable to care for him/herself. One or both parents provided more than half of the child s support for the year. Parents are divorced, legally separated, or lived apart at all times during the last six months of the calendar year. One or both parents had custody of the child for more than half of the year. You were the child s custodial parent, defined as the parent with custody for the greater portion of the calendar year; OR if parents have equal custody (same number of nights), then the parent with the higher adjusted gross income is the custodial parent.

15 Dependent Day Care Flex Spending Account Eligible Expenses Daycare expenses Before and after school care Nanny expenses Nursery school Registration fees Elder care Ineligible Expenses Tuition Transportation Activity fees/supplies Field trips Overnight camp Health Care Expenses For a complete list of eligible expenses, visit the irs.gov website

16 Dependent Day Care Flex Spending Account Dependent Day Care FSA vs. Child Care Tax Credit Generally Dependent Day Care account provides greater savings. Can use both the Dependent Day Care account and Tax Credit but only up to the IRS max contribution limit. Tax credit is not available if married and filed separately. You may claim eligible expenses only once, either via the Dependent Day Care account or the Child Care Tax Credit. Dependent Day Care FSA and TASC Card Convenient way to pay for day care expenses Substantiation will be required for expenses TASC Card balance reflects payroll deductions

17 Parking Account Contribution Limits/Availability No minimum contribution Parking Max contribution: $255/month Election amount is available as payroll contributions are received Election amount will be divided out equally based on employees payroll schedule throughout the year Election changes can make changes at anytime TASC Card Convenient way to pay for parking & transit expenses No substantiation required, however, keep your receipts and documentation in case of IRS audit TASC Card balance reflects payroll deductions so TASC Card may not have a balance until first deduction

18 Parking Account Eligible Expenses Park n Ride Parking lots Parking ramps Ineligible Expenses Tolls Pretax parking expenses deducted from paycheck For a complete list of eligible expenses, visit the irs.gov website

19 Transit Account Contribution Limits/Availability No minimum contribution Transit Max contribution: $130/month* * Note: Contributions of $130 is pre-tax State and Federal. Employees may contribute up to $255 however, contributions over $130 up to $255 would be pre-tax federal and post-tax state. Election amount is available as payroll contributions are received Election amount will be divided out equally based on employees payroll schedule throughout the year Election changes can make changes at anytime TASC Card Convenient way to pay for parking & transit expenses No substantiation required but keep your receipts and documentation in case of IRS audit TASC Card balance reflects payroll deductions

20 Transit Account Eligible Expenses Bus Train Subway Vanpool Ineligible Expenses Tolls For a complete list of eligible expenses, visit the irs.gov website

21 Participant Responsibilities Receipts/Documentation Meet all documentation requirements Agree to retain, verify, and reconcile transactions and receipts Follow-Up Check TASC online account and often Submit eligible document, if requested Submit repayments if expense is ineligible Contact Information Maintain up-to-date contact information ( , mailing addresses, phone numbers, etc.) Adhere to Plan Rules Eligible expenses only Expense was for eligible plan participant (includes dependents) Expense was incurred during an eligible plan year/coverage period Expense was not been previously reimbursed under any benefit plan Expense will not be claimed as an income tax deduction Under IRS and Treasury regulations, all payments from benefit accounts require third-party documentation. Failure to follow above responsibilities may result in TASC Card suspension, repayment of expenses or the collection or withholding of funds from participants pay (to the extent permitted by law).

22 Enrollment Open Enrollment Employees must enroll (and must re-enroll) during the annual open enrollment period Open Enrollment Dates: October 17 November 11, 2016 Open Enrollment Training to be scheduled at end of September More information regarding the 2017 Open Enrollment coming soon!

23 Enrollment Newly Hired/Eligible Employees Enrollment Deadline 30 days following the date of hire/eligibility Enrollment Effective Date The first of the month following the new enrollment/change of enrollment. The date of the event for birth, death, adoption, or placement for adoption. First Contribution Date: Dependent on payroll cutoff date and Date payroll/benefits office notified of enrollment/change of election TASC Enrollment Process Enrollment is verified/processed by payroll/benefit staff Enrollment is sent to TASC TASC processes the enrollment and participant receives Enrollment confirmation and welcome letter via (if on file) or mail (if no on file) TASC Card will be mailed to participants home address within 7-10 business days. TASC Card will be delivered in an unmarked, plain white envelope.

24 Enrollment Tips for determining Annual Election Amounts Estimate/calculate expenses Be conservative Unable to change annual election amounts without qualifying event Review plan contribution limits Review eligible/ineligible expense lists Don t forget vision/dental expenses like eye glasses, contacts, Lasik, orthodontia, etc. Don t forget expenses for eligible dependents Health Care FSA allows up to $500 carryover Limited Purpose FSA allows up to $500 carryover Use the Flex Spending Account Worksheet to assist with estimating/calculate savings

25 Reimbursement Reimbursement Options: TASC Card: Swipe TASC Card at the point-of-purchase. Request a Reimbursement: If expense was paid for out of pocket Submit via Mobile App (free download). Submit via TASC online account. Fax a Request for Reimbursement Form to TASC. Mail a Request for Reimbursement Form to TASC. Reimbursement Request Tips: Claims are processed daily Reimbursements issued via check or direct deposit within hours. Minimum check reimbursement of $10 Make sure to include receipts and documentation to support claims The Request for Reimbursement Form is available on the TASC online account and in the Participant Guide.

26 TASC Card TASC Card Advantages Provides easy payment for eligible expenses. No out-of-pocket expenses. Available for all accounts. Auto-substantiates most eligible expenses. Receiving TASC Card TASC Card will be mailed to participant s home address upon enrollment. TASC Card will be delivered in an unmarked, plain white envelope. TASC Cards are good for 4 years. Additional cards for spouse/dependent over age of 18 available at no charge. Lost/Stolen TASC Cards Report immediately via the TASC online account. Contact TASC Customer Care if there are any fraudulent charges.

27 TASC Card TASC Card Usage Limited to eligible expenses based on the account type. Limited to merchants with an inventory information approval system (IIAS) How TASC Card Works Swipe Card IIAS approves purchase of eligible items and checks available balance Amount is deducted from participant s account TASC Card Denials Common Denial Reasons Insufficient Funds Ineligible Item OTC drugs, other non-eligible items Expense outside of coverage period or plan year Inactive Cards due to unsubstantiated claims What to do when TASC Card denied Pay out of pocket and submit request for reimbursement Check TASC Online Account or Mobile App to determine if balance issue or inactive card For more detailed information on the TASC Card and IIAS, please refer to the TASC Card section in the Participant Guide.

28 TASC Card Substantiation General Information Flex Spending Accounts require third-party substantiation documentation for all eligible expenses per IRS guidelines. Types of Substantiation Auto Substantiation Copay matching $15 office visit copay Recurring Claims Fixed monthly orthodontia payments, lab tests, etc. Real-time substantiation IIAS transactions Manual Substantiation All purchases not auto-substantiated Lab, x-ray, OTC, non copy amount RX and doctor visits

29 TASC Card Substantiation Substantiation Notification Process TASC will send up to three Substantiation notifications via (if is on file) or mail (if no on file): One day after the TASC Card transaction 15 days after the initial TASC Card transaction 30 days after the initial TASC Card transaction Participants have 45 days after a transaction to submit required substantiation documentation. Otherwise, Claim will be denied, Repayment will be requested, and TASC Card will be suspended Failure to repay the claim or provide necessary documentation, will result in the claim amount being withheld from their paycheck. TASC Card will be activated within 48 hours after receipt of proper substantiation documentation or repayment.

30 TASC Card Substantiation Substantiation Documentation Health Care and Limited Purpose FSA Substantiation documentation require the following: Patient name (person who received the service) Provider name Provider address Date of service The amount charged or your cost (e.g. deductible or copay amount not covered by your insurance) Type of service provided Name of the drug (and Rx number if a prescription), if applicable. Dependent Day Care FSA Substantiation documentation require the following: Dependent name (person who received the service) Dependent age Provider name Provider address Provider SSN or TAX ID number Start and end dates of service The cost Parking/Transit Accounts do not require substantiation. Keep receipts and documentation in case of an IRS audit.

31 TASC Card Substantiation Ways to Submit Substantiation Documentation Four ways to submit documentation: Attach the receipt to the request for reimbursement. Upload the receipt to the claim in the TASC online account. Use the mobile app (free download) to photograph the receipt and attach it to the claim. Submit the receipt along with your printed Substantiation Notification, via fax or mail. Examples of documents with all required information: a statement from provider/merchant an invoice from provider/merchant a bill from provider/merchant an Explanation of Benefits (EOB) from health insurance provider Examples of documents that lack all required information: credit card receipts with no description of service canceled checks.

32 Qualifying Events/mid year changes General Information IRS Qualifying Event is required to make any mid-year election changes for the following accounts: Health Care FSA Limited Purpose FSA Dependent Day Care FSA Examples of some common qualifying events: Marriage Divorce Birth Dependent no longer eligible Coverage Period Change in Status A mid-plan year election change will result in split periods of coverage. Any funds balance from a previous period of coverage can combine with amounts contributed after a permitted mid-plan year election change and can be used through the plan year end. Any expenses incurred before the permitted election change can be reimbursed only up to the annual election amount in effect prior to the change. For a list of IRS Qualifying Events, please reference the Qualifying Events chart in the Participant Guide.

33 Qualifying Events/mid year changes TASC Qualifying Event Change Process: Qualifying event is verified/processed by payroll/benefit staff Enrollment change is sent to TASC TASC processes the enrollment change.

34 Termination/Retirement

35 TASC Online Account Website: View account balance and details. View claims history. Submit claims (then upload, fax, or mail documentation to us). Submit Substantiation documentation. Sign up for Direct Deposit. Order additional TASC Cards. Access forms and the Participant Guide. Initial Access provided in TASC Welcome Letter TASC Username: first initial, last name, date of birth (mmddyy), and last 4-digits of your Social Security Number TASC Password: same as username described above. Participants will be required to create a new, unique password and set up security questions upon initial login.

36 TASC Mobile App The TASC mobile app provides instant access to account information on the go, 24/7/365. View account balance and details. View Claim status and history. View Payment status. Submit request for reimbursement. Upload documentation. View notifications and more. Mobile App Download Available for free on the Apple itunes App Store or the Android Marketplace Search for eflex Benefits to download. Mobile App Log In To log into the App, enter TASC online username and password. Participants will be required to create a 4-digit PIN upon initial log in. Enter the 4-digit PIN to access mobile app.

37 Forms Any FSA Account Appeal Information Form Authorization for Release of Information Form Change of Address Form Change of Election Form Claim Repayment Form Direct Deposit Authorization Form Employee Reimbursement Account Enrollment Form Employee Reimbursement Account Information Flyer How to Enroll Online Flyer Participant Enrollment Guide Payroll Transfer Form Request for Reimbursement Form Dependent Care FSA Forms Dependent Care Contract Dependent Care Qualifications Flex Spending Account Worksheet Health Care FSA Forms Carryover Authorization Form Eligible and Ineligible Expenses Flex Spending Account Worksheet Letter of Medical Necessity Orthodontia Worksheet Limited Purpose Health Care FSA Forms Carryover Authorization Form Flex Spending Account Worksheet Letter of Medical Necessity Limited Purpose Health Care FSA Information Flyer Orthodontia Worksheet Parking & Transit Account Forms Transit & Parking Pretax Commuter Benefits TASC Card/Mobile App Additional Debit Card Request TASC Cardholder Agreement TASC Mobile App Flyer

38 TASC Customer Care PHONE: or HOURS: Monday-Friday, 8 am to 5 pm in all time zones FAX: customercare@tasconline.com ONLINE: MAILING ADDRESS: PO Box 7511 Madison, WI 53707

39 TASC Payroll/Benefit Office Resources Relationship Management Team:* Relationship Managers: Kim Fancher ext Kym Starker Client Account Executive: Amy Stark *The Relationship Management contacts are for payroll and benefit staff only. Do not distribute to employees. ONLINE: Access to reports, forms and Administration Guide

40 Q&A If you have any questions, please submit them using the Chat feature. All questions and answers received will be ed to everyone as part of the training follow up.

41 Upcoming TASC Trainings HSA 101 End of August Open Enrollment End of September 2016 Advanced ERA and Advanced HSA to be determined More information regarding upcoming TASC Trainings coming soon!

42 We appreciate your feedback! We are interested in what you thought of this training session. The candid and valuable feedback gathered allows TASC to enhance the training sessions to better meet your needs.