Health Care Retirement Account/RHCA Processing · Retirement Health Care Account (RHCA) •While...

Health Care Retirement Account/RHCA Processing

08/2016

Contents

• HRA Information

• RHCA Information and How to Allocate Funds For Premium And Claims Reimbursement

• Steps to Receive Reimbursements

• How to File a Claim OnLine

• How to File a Paper Claim

• Direct Deposit

• Requirements for Premium Reimbursement (with examples)

• Frequently Asked Questions – Premium Claims

• How to Request Account Notifications

• Who to Contact and How to Get Quick Start Guides and Forms

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Healthcare Retirement Account (HRA)

• For retirees and spouses age 65 and over

• HRA Credits are currently up to $1,975 for Retirees and up to $1,750 for Spouses

• Contribution is based on your age/service subsidy

• Use to pay for:

• Medical insurance premiums

• Other health care coverage such as dental, vision and hearing, deductibles, coinsurance and copayments, prescription drugs, over-the-counter medications (with a valid prescription) and medical supplies.

• Expenses must be incurred in the current plan year to be eligible for reimbursement from the current year’s credit. “Incurred” means the date the service or coverage is provided, not the date the expense is billed or paid.

3

Retirement Health Care Account (RHCA)

• While you were an active employee, your RHCA was funded by your employee contributions and RHCA matched funds. Your RHCA assets are housed at Merrill Lynch, where you have a variety of investment options.

• RHCA funds can be used to pay for health care premiums and out-of-pocket health care expenses for you and your eligible dependents.

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If requesting reimbursement from RHCA …

• RHCA Balance will show as “zero” since WageWorks does not store these balances

• All balances are held with Merrill Lynch

• When you submit your RHCA claim, the claim amount is withdrawn from your RHCA’s Institutional Money Market Portfolio II (“Institutional”) Fund.

5

Additional RHCA Information

• Merrill Lynch will not liquidate any individual equities or stocks.

• You must have enough money available in the Institutional Fund to cover your claim.

• RHCA funds that are set aside to cover premium shortfalls cannot be used for other claims too. Assets in the Institutional Fund that are frozen to pay for medical premiums cannot be used for other claims. However, the balance of RHCA funds remain available for claims reimbursement and investment opportunities.

• Initiate the transfer of funds

• Online at www.benefits.ml.com

• Call the Merrill Lynch Retirement and Benefits Contact Center at 1-800-483-7283.

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Steps to Receive Reimbursement Complete a Claim Form – Online or Fax/Mail

• For Premium Reimbursement

• Provide Proof of Coverage showing Name of covered individual(s), Health Care Plan Name, Date(s) of coverage period, Type of expense (Premium), Premium Amount . May provide:

• Coupon Slips from insurance company or

• Itemized Statement from the insurance company or

• Letter from the insurance company

• Provide Proof of Payment

• For Health Care Services

• Provide Receipt - Must include:

• Name of service provider or retailer

• Date of service or purchase

• Identification of drug or product, or description of service

• Purchase amount of each product or service

• Total purchase amount

Additional information in following slides

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How to File a Claim Online

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Select the Description of

Service from the drop

down menu. Then select

“Other"’ to produce more

options such as “Health

Insurance Premium”.

Enter the amount and the

name of the retiree or

dependent and hit the

“Next” button.


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Confirm the

summary and

Click Submit

Claim.


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How to File a Claim Online (con’t)

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How to File a Paper Claim Form

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Example Claim Form

How to File a Paper Claim Form (con’t)

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Medicare premiums paid through Social Security

Medicare premium reimbursement not paid through Social Security

Reimbursement for other qualified expenses

How to File a Paper Claim Form (con’t)

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Sign and Date

DIRECT DEPOSIT

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Example Claim Form 3:

Then

se

lect

Dir

ect

Dep

osi

t

Complete the banking information and click “Save Changes”

Requirements for

PREMIUM

Reimbursement

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Proof of Coverage Requirements

• For Medicare Premiums deducted through Social Security, the best documentation is:

• Social Security ‘Cost of Living

Statement’

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Social Security ‘Cost of Living Statement Example:

PART D

PART B

Effective Date

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Proof of Coverage Requirements

• Proof of Coverage is documentation from the insurance carrier: • Policy Statement • Receipt • Invoice • Coupon Book • Letter from the Insurance Carrier

• Proof of Coverage must contain 5 pieces of information: • Insurance Company Name • Policy Holder’s Name – Retiree or Spouse • Date of Service – Coverage Date(s) • Type of Service – ‘Medical Premium Payment’ • Premium Amount

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Proof of Coverage Example for Drug Plan Part D:

Policy Statement Coupon Book

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Proof of Payment Requirements: • Proof of payment can be any of the following (only one

is required):

• Bank statement or credit card statement that shows your payment

• Participant Name and the Banking Institution must be visible

• Health Plan statement showing that payment has been posted

• Screen print-out from banking site showing that check has been cleared

• Proof that the check is a cancelled check (payment amount & bank stamp must be visible)

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Proof of Payment Example for Medicare Supplement Plan F: Health Plan Statement

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Pension Payments • Retiree Medical Premiums

• Retiree Medical Premiums that are paid where we have documentation showing the payment was made from a pension payment are eligible.

• Indicators for a pension payment are the word Retirement: ~~ Retirement Systems ~~ Retirement Plan/Program ~~

• Retiree Medical Premiums that are paid where we have documentation showing the payment was made from an employer pay check are NOT eligible.

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Pension Check Stubs – Sample

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Pension Check Stub – Sample

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Frequently Asked Questions – Premium Claims

• Can the participant be reimbursed for Premiums for the entire year by submitting only one claim?

• Yes. In order to do so, they need to complete a claim form indicating with the dates of service for the entire year (i.e. 01/01/16-12/31/16) and the annual premium amount.

• The participant must provide Proof of Coverage and Proof of Payment for one month.

• WageWorks will enter the claim with the dates of service for the entire year and the annual amount. Claims reimbursements are then prorated on a monthly basis based on the service dates going forward from the month we received documentation for proof of coverage and proof of payment. Payment is made at the beginning of each month automatically once the annual claim has been established.

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Questions….

• What if the insurance premiums (quarterly or annually) are paid in full, can the participant be reimbursed the full amount or will the claim be prorated?

• WageWorks will reimburse insurance premiums that are paid in full even if in they are advance of the insurance coverage period (service dates rendered).

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Questions….. • If the insurance premiums (quarterly or annually) are

not paid in full, can they be reimbursed in full or are they prorated?

• Insurance premiums that are not paid in full are prorated out on a monthly basis when the insurance coverage dates (service dates) are in the future.

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How to Request Account Notifications

Participant Notifications

• Online view of all activity is available at anytime.

• Notices are emailed upon receipt of claim.

• Mailed notice will be sent if participant does not have email address on file.

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Claim has been processed; How to request the detail Receive Email confirmation that claim has been processed

NOTE: To protect personal information, the status of the claim detail (i.e. denial, denial reason) is not included on the notification

• To receive claim detail:

• 1- Log into your account and view status of claim OR

• 2- Call WageWorks customer service at 1-877-924-3967

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Detailed Notifications

• To receive more detailed notifications, update your preferences in “PROFILE”

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Detailed Notifications

• Click on Preferences

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Detailed Notifications • Check the box ‘Detailed Emails’ authorization WageWorks to send

detailed notifications regarding claims that have been processed

• Check “Account Balances” if you’d also like to receive your balances

• Then save your changes

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Who to Contact • Contact Benefit Connect at 888-409-3300 regarding eligibility

• Contact Merrill Lynch to get account balances, fund transfers, contributions

and distributions, earnings, and to freeze/move funds for premium

payment/reimbursements

• Online at www.benefits.ml.com

• Call the Merrill Lynch Retirement and Benefits Contact Center

at 1-800-483-7283

• Contact WageWorks for Claims Processing, Account Activity, and Details

• Online at wageworks.com (24/7)

• Call WageWorks at 1-877-924-3967

• Representatives are available Monday – Friday 8 am- 8 pm Eastern

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http://www.benefits.ml.com/

http://www.wageworks.com/

Quick Start Guides, Forms, etc.

• Online: fcaretirees.com or chryslerretirees.com

• Or call WageWorks at 1-877-924-3967

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After selecting

“Salaried Non-

Represented

Retirees”, the RHCA

and HRA Guides and

Forms are on the

bottom right side of the page.

Thank you.

44 08/2016

Health Care Retirement Account/RHCA Processing · Retirement Health Care Account (RHCA) •While...

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Transcript of Health Care Retirement Account/RHCA Processing · Retirement Health Care Account (RHCA) •While...