FSA Proposal. Presented by: O. C. A. B E N E F I T S E R V I C E S, L L C.

Transcription

1 FSA Proposal Presented by: 2015 O. C. A. B E N E F I T S E R V I C E S, L L C.

2 In 1983 O.C.A. Benefit Services opened its doors with one goal; to help people. Since then O.C.A. has grown to a national TPA, servicing over 100,000 lives across the United States. O.C.A. Executive Summary For more than 30 years, O.C.A. Benefit Services, LLC (O.C.A.) has been a leader in the employee benefits arena with a commitment to customer service through creative and cost effective benefit plan designs. We are not just an administration company, but rather an Employee Benefits Delivery Organization established to provide employers, agents, brokers, and plan participants with the most cost effective and efficient benefit packages available. We believe that quality healthcare is actually less expensive to deliver than poor quality healthcare. While we recognize the very nature of human behavior is to resist change, we also need to embrace the reality that Consumer Empowered Health Plans (CEHP) are the cure to rising health care costs and poor quality health care delivery. Our approach is candid, open, and honest. We believe in setting fair and reasonable expectations with all the parties involved. We understand that keeping the process easy is critical to the implementation of the program, but we also understand that sacrificing compliance will eventually catch up with a client in direct or hidden costs. Our role is more than just a Third Party Administrator, but as a portal of reliable information and education. The Plan Participant will once again be engaged as a consumer of health care. Dependents Broker O.C.A. Clients Employee Employer We thank you for your interest in learning more about our administrative services. Please do not hesitate to contact us with any questions. Sincerely, Stephen Honig President, O.C.A. Benefit Services

3 O.C.A. administrative services 1986 began offering FSAs. In 2004 we wrote our first HRA case. In 2007 we began offering COBRA, Wellness, & Parking/Transit administration. The Services We Offer... O.C.A. Benefit Services offers a complete suite of Administrative Services including: Plan Design Consultation, HRA Administration, Cafeteria Plan Administration (POP/FSA/DCAP), HSA Administration, COBRA/Retiree Billing Administration, Parking/Transit Administration, and Wellness. With any employee benefit program, plan design is the first, and probably the most important step in creating an effective program. Each worksite situation is unique, so the key is to design a plan to achieve your specific goals. HRA FSA COBRA Parking/Transit Wellness HSA In the United States, the problem is not with the cost of health insurance. The problem is with the cost of health care. Until we control the cost of care, we will never gain control over the cost of the insurance.

4 On October 31, 2013, the IRS made an exciting change that affects Flexible Spending Accounts! They modified the use it, or lose it rule which required any leftover balance in an FSA to be forfeited at the end of the plan year. This new plan allows employees to carry over up to $500 of unused FSA funds at the end of the plan year so employees no longer have the risk of losing their set-aside money! What does O.C.A. stand for Organize Commuicate Achieve Flexible Spending Accounts (FSA) An FSA is a program that allows employees to pay for qualified medical, dental, vision, and dependent child care related expenses with pre-tax dollars. These plans are one of the most popular benefits around, for good reason. Employees like Flexible Spending Accounts because they can pay for out of pocket expenses with pre-tax dollars, giving employees more take-home pay! Each employee may elect up to $2,500 for qualified medical, dental, and vision related expenses and up to $5,000 for dependent care expenses such as day care and summer camp. Why choose O.C.A.? The process of creating an audit compliant FSA program does not have to be complicated. Like any Qualified Plan though, certain IRS FSA requirements must be adhered to. At O.C.A. Benefit Services we strive to create an environment for you to successfully create this unique win/win benefit program. When you select one of our full service plans, working together, we will help you create the required trail of data necessary to produce a plan that can withstand a government audit. Our administrative solution lets you effectively administer Flexible Spending Accounts (FSA), Dependent Care Assistance Plans (DCAP), and Premium Only Plans (POP) with simple benefit arrangements

5 Did you know that under an FSA, self-employed individuals (e.g., sole proprietors, LLC, partners in a partnership, and greater-than 2% as shareholder (and direct family members) may not receive tax free benefits? This is due to the ownership attributions rules under IRS Code 318. Why Employers Offer an FSA Employers choose to implement Flexible Spending Accounts to help their employees save substantial tax dollars, with some tax saving for employers too. The extent to which an employer will experience tax savings and other advantages depends on the type of plan, the nature of the workforce, and in some cases state and local laws. Employers may: Realize FICA and FUTA savings with salary reduction Save under state unemployment insurance and workers compensation Increase employees awareness of benefit costs Cushion the blow of premium increases When all said and done, an established FSA program can yield more dollars in tax savings than the fees spent to administer the plan. One of O.C.A. s current FSA clients with 50 participants generated $4,200 in FICA savings which netted the employer a net gain after administrative fees. Below are some key changes to FSAs as a result of healthcare reform heading into 2015: Max FSA Contribution Capped at $2,550: The limit is a flat dollar amount and applies on a peremployee basis, regardless of how many other individuals' medical expenses are reimbursable under the employee's health FSA (e.g., a spouse or other family members). Thus, employees with family members are not permitted to make higher health FSA salary reductions. FSA Medical $500 Carryover Option: IRS guidance issued in October 2013 allows health FSAs to offer carryovers of unused balances of up to $500 remaining at the end of a plan year, to be used for qualified medical expenses incurred in subsequent plan years. Offering health FSA carryovers is optional and is an alternative to offering a health FSA grace period-health FSAs allowing carryovers from a plan year cannot also have a grace period with respect to that year. This exception to the use-or-lose rule offers the potential to reduce health FSA forfeitures, which may encourage more employees to participate in health FSAs. It may also ease the yearend spending rush that occurs under many health FSAs. Over-the-Counter Drugs No Longer Eligible Without a Physician Rx: Under health care reform, expenses for OTC medicines and drugs (other than insulin) incurred after December 31, 2010 are only reimbursable if the medicines or drugs are prescribed. For purposes of the new restrictions, a prescription for a medicine or drug is a written, electronic, or other order that satisfies the legal requirements for a prescription in that state (including that it be issued by someone authorized to issue prescriptions in that state). To show that an OTC drug has been prescribed, employees must submit the prescription or other documentation, along with the other independent third-party substantiation required under IRS rules.

6 The uniform coverage rule stated under Prop. Treas. Reg (d)(1) requires that "the maximum amount of reimbursement from a health FSA must be available at all times during the period of coverage. That is, the maximum amount of reimbursement under a health FSA must be available at all times during the period of coverage (generally the 12-month plan year), reduced only for any prior reimbursements for the same period. Our FSA Services Include Preparation of FSA Legal Documents: O.C.A. will create a customized plan document outlining the provisions of an employee benefit plan. Customized Employee Communication Material: Whether it s a group of two or a group of five thousand, O.C.A. will create customized employee communication material based upon the groups plan design. O.C.A. provides industry expertise with top of the line representation. We represent our clients by educating and assisting employers, employees and their families. Client Customer Service: We are committed to our client relationships and it shows from the effort we put forth that our clients needs are professionally, courteously and personably satisfied. The member service department is open from 9:00 am to 5:00 pm Eastern time Monday through Thursday and until 4:30 pm Eastern time on Friday. O.C.A. also provides members 24/7 access to account balances through our website, 24/7 access thru our Interactive Voice Recognition Phone System (IVR) as well as a mobile application on the Android and iphone. Annual Non-Discrimination Testing (Upon Request): Annual discrimination tests are designed to show that eligibility and plan benefits are applied fairly and consistently, which in turn allows the plan sponsor to avoid unfavorable tax consequences. Daily Claim Adjudication processing: Claims are typically processed within 48 business hours of receipt. All claim are 100% manually audited. Direct Deposit of claim payments: Direct deposit of employee claims is efficient, environmentally friendly, and saves money. Imagine submitting a claim to O.C.A. Benefit Services at 9:00 a.m. and having that claim processed either the same day or at the latest, the next business day. Employer Contribution Billing Reports: O.C.A. will process and send employer pay cycle contribution billing reports to ensure newly eligible employees, terminated employees, employees on leave, and many other scenarios are reported timely to ensure accurate reimbursements are made.

7 In 2007, the IIAS Standards Interest Group incorporated as SIGIS: Special Interest Group for IIAS Standards. And in January 2008, the SIGIS standard was launched, enabling merchants to meet the new IRS requirements. SIGIS also initiated a merchant certification for support of its IIAS Standard and made the SIGIS Eligible Product List available for use by Member merchants and benefit plan administrators. Electronic Payment Card O.C.A. s mysource MasterCard debit card provides account holder convenience with single-source access to HRA, FSA, and HSA dollars and expedites claim processing through industry standard autoadjudication parameters. Electronic payment cards are becoming more prevalent and vital in a successful benefit plan offering. Introducing an electronic payment card into a reimbursement account plan empowers employees and gives them an option to avoid inconvenient out-of-pocket expenses. The mysource MasterCard debit card increases participation in group plans, increases employee contributions to tax-advantaged accounts and associated employer FICA savings as well as giving employees instant access to plan dollars. I.R.S. Regulations Pertaining to Health Debit Cards The Federal government requires certain debit card transactions be substantiated via the submission of necessary supporting documentation that supports the charge. If supporting documents are not provided (typically within 30 days of the swipe), these regulations require the card be timed-out (temporarily suspending the use of the card) until said documents have been provided to O.C.A. There are claims that will auto substantiate without the need for submitting documentation and want to identify those rules to eliminate confusion and frustration. O.C.A s mysource Debit card will work and auto-substantiate at vendors (i.e. CVS, Walgreens, RiteAid, etc.) that have gone through a certification process (referred as I.I.A.S.). This certification process itemizes expenses as deemed eligible under IRS Code 213(d), which is the complete list of FSA approved expenses. It is also important to know that mysource Debit Cards are also able to be used at merchants such as doctor s office, dentist, optometrist, hospital, and others. However, these approved locations (merchants) were exempt from the same requirements that govern the certification process that the vendors went through (IIAS). That said, using the mysource Debit Card at these locations will almost (with few exceptions) always require supporting documentation be submitted.

8 O.C.A. offers myrsc mobile application! Our mobile app is available on the iphone or Android based phone. Employee s can view account information, manage their HRA benefit, and even submit a claim using our SnapClaim feature! myrsc Online Access Employers and their employees will have 24/7 access to our secure web portal called myrsc (My Resource Service Center). myrsc provides each user a customizable view based on whether the user is the employee, or human resource administrator. Employer will have the ability to access FSA distribution/contribution reports, employee account balances, payment history, and much more! The single most distinctive characteristic of the site is its adaptability and its ability to fit the purpose of any user. myrsc Mobile Access Employees can now access their benefit account information on their Smartphone with the Mobile myrsc app for iphone and Android. Simply search for myrsc on the App Store for Apple products or on the Google Play Store for Android products, and then load as you would any other app. Participants have access to: View account balance information Debit card transaction history File a claim and upload photos via the SnapClaim feature Change your personal information Our FSA solution offers maximum flexibility for virtually unlimited plan design capability, plus 24/7 online account information via myrsc.com/mobile myrsc, and linked mysourcecard debit card.

9 Our customized communication kits and emphasis on education increases employee participation, which generates increased FICA savings for the employer Requested Quote for FSA Administration Services Annual Fee Rate PPPM FSA $500 $6.00 $50 Monthly Minimum Additional Service Fees May Apply Paper Check Reimbursement $1.00 Per Check Issued For additional information please contact: O.C.A. Benefit Services Sales Department (609) or