ASI FUNDING PLANS. What is an ASi Funding Plan?

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1 ASI FUNDING PLANS What is an ASi Funding Plan? The ASi Funding Plan is a benefit plan that can provide you and your employees with significant savings without diminishing your benefits. With this plan, eligible employees can be reimbursed by their employer for eligible out-of-pocket medical expenses. The plan provide a tax-free benefit to your employees and are deductible business expenses. Another plan ASi offers is the Cafeteria or Section 125 Flexible Spending Plan, which is also a tax advantaged benefit that is funded by the employee. This plan can be used to pay for an employee s eligible out-of-pocket medical, dental, vision and prescription expenses. The difference between the two plans is as follows: ASi Funding Plan*: The employer pays the cost of the reimbursements. Flex Plan: The employee pays the cost of reimbursements through per pay period salary deductions. * Must be tied to a Group Medical Plan

2 AT A GLANCE ASi Funding Plan...At a Glance How does it work? By setting up an ASi Funding Plan, employers can raise deductibles without passing on the cost to employees by covering the expenses under the deductible. This plan saves both the employer and employees money, all at the same time! With an ASi Funding Plan, employers agree to pay for part of their employees medical expenses. The employers will offer one deductible to the employees and partner with an insurance carrier to put a higher deductible into place. The difference between the two deductibles is the portion that becomes self-funded. This means that the employer will reimburse the employee or provider up to that specified amount. Employer buys a high deductible plan. Employer designs a benefit plan under the high deductible plan and utilizes ASi for the ongoing administration. (Example: $250.00, 80%, $20 co-pays) Complete benefits to the employee The Details

3 HOW IT WORKS How a Claim is Paid between the Carrier and ASi: When going to a contracted doctor/provider, hospital, lab and/or pharmacy (if applicable), ALWAYS show your carrier ID Card and your ASi ID Card. You must show your ASi ID Card in order to receive your employer funded benefits. 1 Doctor/Provider Go to an in-network provider and pay any applicable co-pay, if required. 2 Carrier Provider sends your claim to the carrier for processing. If approved, it will be applied to the Carrier Deductible. 3 Employee The Carrier will send you an Explanation of Benefits (EOB). It is then your responsibility to send your EOB to ASi. (You can fax your claim to or it to claims@asibenefits.com. You can also sign up for ASi s EOB Retrieval Service, where ASi will obtain your EOB directly through your carrier s website, or you can download the ASi Smartphone App and submit your claims directly from your phone.) 4 ASi ASi will process the claim, applying the benefits your employer has designed under the Carrier Deductible and send payment to your doctor/provider. You will get a copy of the ASi EOB detailing what was sent to your doctor/provider so you are aware of your portion of the payment, if applicable. Please Note: Prescription coverage may vary. Please refer to your Schedule of Benefits for your applicable co-pay and coverage level.

4 HOW AN EMPLOYER FUNDS How an Employer Can Fund the Account Funding Option #1 - ASi Banking ASi opens up a banking account which allows us to process the benefits designed by the employer. ASi prepares the checks, then notifies the client of the amount necessary to fund that week s claims. Employers may pre-fund the account or fund each check run. However, in order for the claims to be paid in a timely fashion, ASi requires a minimum to be funded in advance. ASi will send a check request to replenish funds on a weekly basis, or as requested by the employer. Employer may choose to have ASi pull the necessary funding electronically, or the employer can initiate the transfer to ASi. Funding Option #2 - Employer Banking Employer will send a voided check to ASi in order to load banking information into our system. All checks will be prepared on the employer s account, and produced by ASi. The checks will then be sent to the employer to sign and forward to the provider. We can also load a digital signature for this account and release checks directly. Funding Option #3 - Debit Card ASi will link employee funds to a debit card, also known as the Benny Card. This will allow employees to swipe the debit card to pay for medical expenses that will draw directly from an employer account. Debit Cards require a 5% deposit of the aggregate participants annual election amounts. Deposits must be received prior to debit cards being issued. The Debit card s security deposit will be refunded after 120 days from the plan termination. An ACH authorization form is required.

5 SAVINGS December through November 2015 (12 Lives) Average Monthly Lives 12 Carrier Premium $140, Actual Claims $35, Projected Claims* $7, *Estimated claims for remaining plan year Administration $4, Total $187, Monthly Average $15, Compared Plan Blue Shield Ultimate PPO 150 $193, Your Savings $6, December through November 2015 (29 Lives) Average Monthly Lives 29 Carrier Premium $218, Actual Claims $103, Projected Claims* $20, *Estimated claims for remaining plan year Administration $13, Total $356, Monthly Average $29, Compared Plan Aetna Platinum MC Copay Plan $442, Your Savings $86, October 2014 through September 2015 (46 Lives) Average Monthly Lives 46 Carrier Premium $250, Actual Claims $17, Projected Claims* $3, *Estimated claims for remaining plan year Administration $11, Total $283, Monthly Average $23, Compared Plan Blue Shield Preferred Full PPO 0 $352, Your Savings $68,861.18

6 DENTAL & VISION Dental & Vision Can I offer Dental/Vision coverage under the ASi Funding Plan? An employer can offer their employees a dental and/or vision plan without buying an expensive plan through an insurance carrier. ASi offers a funding plan that allows employers to reimburse their employees vision and/or dental expenses. This gives employees the assurance of knowing they can get day-to-day dental and vision expenses covered without costing the employer the high cost of paying a monthly premium. This way, the employer only pays provider for the employees who actually use the benefit. Benefits can be structured to mirror a fully insured plan, or can be an upfront benefit. Questions & Answers