PEHSP The Post-Employment Health Savings Plan Cedar Rapids Education Association

Transcription

1 PEHSP The Post-Employment Health Savings Plan Cedar Rapids Education Association Steve Ott, Regional Vice President 9202 West Dodge Road, Suite 302, Omaha, NE PH: ext. 1351/FX : sott@nisbenefits.com Stacy Wanderscheid Perspective Consulting Partners

2 What is PEHSP? It is a negotiated benefit in which the District regularly deposits funds into individual accounts on behalf of teachers while they are employed. These Funds, with earnings, are used tax-free by a teacher who separates from service or retires to pay for qualifying medical expenses and premiums, including but not limited to the District s health insurance plan. 2

3 The Team NIS (National Insurance Services) is the face of the plan, providing onsite service and support. NIS also coordinates the activities of: The Plan Administrator MidAmerica (MidAmerica Administrative & Retirement Solutions) 402 South Kentucky Avenue Suite 500 Lakeland, FL The Investment Provider American United Life Insurance Company, a ONEAMERICA Company (AUL) 3

4 Costs and Fees Administrative Fees There is a participant administrative fee of $5 per quarter ($20 per year). This fee ceases when a participant leaves employment or retires. Participants eligible to access funds for reimbursement of eligible medical expenses and premiums will be charged a $5 per reimbursement claim fee. This fee is reduced to $2.50 per claim if the claim is submitted online. Claim fees are assessed on an annual maximum of six claims per year. To reduce claim fees and maximize interest earnings, one claim form can be submitted for the entire year for only $5. Fixed Interest Investment*and Asset Based Fees There is a.50% (one half of one percent) annual asset based fee for all variable investments. There is no asset based fee for fixed interest investment. The fixed interest rate of return is *guaranteed as 1.75% through Rates are set annually and are not known until December for the subsequent year. *Fixed interest accounts are not FDIC insured and are guaranteed based on the claims paying ability of the investment provider, AUL 4

5 Where to Get Additional Information The District s website and click on District Resources>Human Resources>Benefits>PEHSP Copy of presentation MidAmerica Investment Change/Transfer Form (used also for initial election) MidAmerica (Plan Type Health Reimbursement Agreement) log into the plan at Account Activity and Balance information AUL Investment Prospectus Investment Change Form Reimbursement Questions and Answers Reimbursement Claim Forms and Directions Your Primary Personal Contact, Steve Ott, sott@nisbenefits.com, Ext 1351 Individual Questions Investment Support Help on Getting Information, Answers 5

6 Claims Submission (does not apply to active employees) To be eligible, you must have either separated from service or retired from the District. The IRS requires you to provide documentation for all expenses submitted. HRA Questions and Answers, Eligible Expenses and Directions can be found at or you can call customer service at Reimbursement Claim Forms can be found by logging into the plan at Using Funds to Continue on the District Health Insurance Plan Complete the MidAmerica Recurring Claim Form. Initial documentation showing the name/type of recurring insurance premium expense to be reimbursed, along with the amount and frequency of the expense is required for the first month of reimbursement. During months 2 12, a monthly I attest statement confirming that the established recurring insurance premium expense continues to be accurate and reimbursable, is required. This statement may be delivered by fax, mail, or electronically. Fax: (863) Mail: P.O. Box 24927, Lakeland, FL Electronic: your attestation to claims@midamerica.biz Your Recurring Claim Form on file with MidAmerica must be renewed annually. MidAmerica will reimburse participants for the full amount or a lesser amount if requested by the participant. 6

7 Claims Submission continued Using Funds For Other Medical Premiums Forwarded to MidAmerica Letter or invoice showing the premium due (first premium request only) with recurring claims Proof that the premium was paid (each time with individual claims) A Recurring Claims Form After completing name, address, etc, make copies for your future convenience Direct Deposit Request Form (once, optional) Using Funds For Other Eligible Medical Expenses Forwarded to MidAmerica Proof that an expense is owed or has been paid, such as an EOB (Explanation of Benefits) A Claims Form (each time) After completing name, address, etc., make copies for your convenience Direct Deposit Request Form (once, optional) Reimbursement Fees The reimbursement fee for premiums and medical expenses is $5 per claim form. This fee is reduced to $2.50 per claim if the claim is submitted online. Claim fees are assessed on an annual maximum of six claims per year. To maximize interest earnings and reduce fees, it is required you accumulate expenses until they total at least $100 or more (not applicable to recurring claims). You can also turn in one claim for the entire year for only $5. 7

8 Summary of Eligible Medical Expenses Partial Listing of IRS Publication 502 Eligible Medical Expenses This is a partial listing of Publication 502 eligible reimbursable expenses. You must read IRS Publication 502 to determine exactly whether or not your expenses are reimbursable. Publication 502 may be obtained at: Acupuncture Fertility Enhancement Osteopath Alcoholism Guide Dog or Other Animal Oxygen Ambulance Health Institute Prescribed Medicines & Drugs Artificial Limb Health Maintenance Organization Psychiatric Care Artificial Teeth Hearing Aids Psychoanalysis Birth Control Pills Hospital Services Psychologist Braille Books and Magazines Insurance Premiums Sterilization Chiropractor Laboratory Fees Stop Smoking Programs Christian Science Practitioner Laser Eye Surgery Therapy Contact Lenses Learning Disability Transplants Crutches Long Term Care Insurance Vasectomy Dental Treatment Medicare Supplements, Part B & D Weight Loss Program Drug Addiction Nursing Services Wheelchair Eyeglasses Operations X-ray Fees If the reimbursement is to the employer or the carrier, then only the one-time Recurring Claim Form is required unless the premium changes. If the reimbursement is paid directly to the participant, then a monthly Attestation Form is required in addition to the one-time Recurring Claim Form. 8

9 American United Life Insurance Company, a ONEAMERICA Company (AUL) American United Life Insurance Company, a ONEAMERICA Company (AUL), headquartered in Indianapolis, Indiana, provides variable and fixed investments. AUL has been in business for over 135 years, has billions in assets under management, and has excellent financial ratings. Cedar Rapids Community Schools can offer to its employees and retirees a wide variety of variable annuity investment options to offer to plan participants covering the entire risk-return spectrum. Investments include actively managed asset allocation portfolios and a high quality fixed interest annuity option. The NAIC, National Association of Insurance Commissioners, annually sets the minimum rate of return for fixed annuities. AUL has an A.M. Best rating of A+ (Superior), the second highest of 16 possible ratings, according to the release dated May Standard and Poor s debt rating of AA- (Very Strong) is the fourth highest of 22 possible ratings, according to its report dated July ( 9