O.C.A. Benefit Services HRA/FSA/COBRA Proposal

Transcription

1 2011 O.C.A. Benefit Services HRA/FSA/COBRA Proposal Broker Name Company Name 11/1/2011

2 O.C.A. Executive Summary For more than 20 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 efficient 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 efficient and effective 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 seek the rewards of being a consumer of health care. O.C.A. Benefit Services offers a complete suite of Administrative Services including the following: Plan Design Consultation Cafeteria Plan Administration (POP/FSA/DCAP) Transportation & Parking Administration HRA Administration HSA Administration COBRA Administration Electronic Payment Cards (MySource Card) Wellness 24/7 Secure Web Portal and I.V.R. Phone System Employer Compliance Reporting

3 HRA, FSA, & COBRA Administration Proposal for: (Company Name) Address: Phone: Number of Eligible Employees: Company Information:

4 Plan Design Consultation Plan design is the first, and probably most important, step in creating an effective employee benefit program. Each worksite situation is unique, so the key is to design a plan to achieve your specific goals. The options can seem endless, and understanding your needs is the best place to start. Whether you choose plans that are fully-insured, self-insured, company provided, traditional, or consumer-driven, O.C.A. representatives have proven and effective skills to develop an ''employee benefit strategy'' that reflects your organizational objectives. For instance, you may want to offer an FSA, HRA, or HSA as a standalone plan. Or you may see the benefit of stacking the plans to include a combination of the three. You may even offer a ''menu'' of plans from which your employees can choose. O.C.A. Plan Design Services include: 1. Complete analysis of your benefit program 2. Establish a goal for the plan, ex: benefit coverage, cost savings 3. Plan formulation to provide a variety of options for your employees 4. Final Plan Design 5. Provide customized on site education to all employees What is a Health Reimbursement Arrangement? A Health Reimbursement Arrangement (HRA) is an employer sponsored plan used to reimburse employees for certain qualified medical-related expenses on a non-taxable basis. HRA s were approved under Treasury and IRS Notice and Revenue Ruling While not required, it is usually offered in conjunction with a high-deductible medical plan which significantly lowers the premium. A portion of this premium savings is used to reimburse plan participants for un-reimbursed medical care expenses as defined by Code Section 213(d) or those limited by your plan documents.

5 The dollar limit required to fund the HRA is set by the employer s plan documents. Any unused amounts can carry forward from year to year or are more commonly refunded back to the employer. While each plan is unique, we are seeing a net employer s benefit cost reduction in the range of 10-25% and an improvement in the quality of healthcare delivered to members. A properly designed HRA encourages the employees to become better health care consumers. As a consumer, quality of care improves and costs are reduced. We will provide employees with access to quality information that can assist their decisions when they need to access care. What is a Flexible Spending Account? At O.C.A. Benefit Services, we strive to create an environment for you to successfully create and implement this unique win/win benefit program. Created under Section 125 of the Internal Revenue Code, Cafeteria Plans allow employees to pay for certain qualified insurance premiums and uninsured expenses with pre-tax dollars. Employees do not pay FICA, federal, or state income tax (except NJ) on their portion of premiums or uninsured expenses. Employers save on their portion of FICA taxes and in many states, FUTA premiums. An employee, employer or both may contribute to an FSA. There are no limits to contributions. However, employers typically set the limit. Effective 01/01/2013 though, the maximum contributions will be limited to $2,500. The maximum annual contribution for Dependent Care Accounts is $5,000 for individuals with dependents or for individuals filing taxes jointly. O.C.A. FSA Administration includes: 1. Premium only Plan (POP) - A POP allows employees to pay their premiums for employer sponsored insurance such as health, dental, or vision on a tax free basis. 2. Flexible Spending Account (FSA) Employees use payroll withholding of pretax dollars to pay for an out-of- pocket medical, dental, or vision expenses. 3. Dependent Care Flexible Spending Accounts Employees use payroll withholding of pretax dollars to pay for work-related expenses associated with care of a live-in dependent, such as a child or elderly relative.

6 O.C.A. HRA & FSA Administrative Services: Preparation of plan documents O.C.A. will create a customized legal document outlining the provisions of an employee benefit plan. Annual discrimination testing and necessary information provided for employers to complete their 5500 forms 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. Customized employee communication material Whether it s a group of two or a group of five hundred, 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 At O.C.A. Benefit Services, we don t just process claims, we work towards educating individuals on the impact they can have on the cost and quality of health care. 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 as well as our 24/7 access thru our Interactive Voice Recognition Phone System (IVR). Daily claim adjudication processing With O.C.A. Benefit Services, claims are typically processed within 48 hours of receipt. All claims are 100% manually audited.

7 Direct Deposit of claim payments Direct deposit of employee claims is efficient, environmentally friendly, and saves money. Imagine submitting a claim in 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. Once processed, the funds hit the Federal Clearing House which typically clears in two to three business days. Once cleared, it will then hit your bank to clear for deposit. You are then free to access those funds to pay your provider for the services that were rendered. For an additional small fee, O.C.A. will pay providers directly on the employee s behalf. Electronic Payment Card for HRA & FSA plan design 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. Card Services provided: Initial card enrollment and account set up Initial delivery of cards to employer by overnight mail Transaction monitoring and reconciliation Customer service to employees Employer and employee access to a 24/7 secure web portal Employers and their employees will have 24/7 access to our secure web portal called Myrsc (My Resource Center). Myrsc provides each user a customizable view based on whether the user is the employee, manager, employer, human resource administrator, payroll processor, benefit consultant, plan service provider, insurance carrier or any person with appropriate access permissions and role authority. As an example, employees will have the ability to enter online claim forms, view benefit history, access debit card activity, and much more! The single most distinctive characteristic of the site is its adaptability and its ability to fit the purpose of any user.

8 What is COBRA? COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, which became law in COBRA allows individuals the right to keep the group health insurance benefits that would otherwise be lost by either a reduction of work hours, or lose of employment. COBRA only applies to employers with 20 or more employees. O.C.A. COBRA Compliance with COBRA and state laws is a challenging task, and errors or omissions may result in fines, tax penalties and lawsuits. Therefore, many employers are following the trend and are turning to professional administrators for their COBRA continuation services. When selecting an administration firm to handle your COBRA compliance, it is vitally important to understand exactly the breadth and depth of services provided. You will find the service of a COBRA Outsourcing Company solves your administration headaches associated with these complex federal regulations. O.C.A. Benefit Services offers employers complete administration and management services for benefits mandated under Federal COBRA laws. Administration through O.C.A. Benefit Services saves your organization time, money, in-house training and potential costly errors. COBRA Administration Services include: Transfer of liability from your organization Full internet-based service capabilities through 24/7 secure online portal Initial Notices Qualifying Event notification to Qualified Beneficiaries and their Qualifying Dependents COBRA election processing COBRA payment invoicing and collection by issuing payment coupons to participants COBRA premium reimbursements to employers Conversion & Termination Letters Rate Change Notices & Open enrollment support Standard monthly reporting for ARRA Subsidy premium reduction reimbursement Handling of all employer and ex-employee questions related to COBRA

9 All fees impact new business only, effective November 1, 2011.

10 (XXX Lives) Requested Quote for HRA/FSA/COBRA Administration Services Set Up/Takeover Annual Fee Rate Per Par/Per Month Total Monthly Cost Total Annual Cost HRA FSA Debit Cards Direct Deposit N/A $500 $8 per/par $50 Monthly Minimum $ $ COBRA N/A N/A *$0.30 pepm $ $ Additional Service Fees *COBRA Notification Notices Paper Check Reimbursement Pay Provider Option $2.25 Per Notice $1 Per Check Issued $3 Per Check Issued For additional information please contact: O.C.A. Benefit Services Sales Department (609) or sales@oca125.com 3705 Quakerbridge Road, Suite 216 Mercerville, NJ 08610