FAQs

COBRA Administration

  1. When are payments due?  All premiums are due on the 1st of every month with a 30-day grace period.  All premiums must be post-marked within the 30-day grace period or else the coverage will end.
  2. Can participants view their information online?  Yes, participants have 24/7 access to their records online
  3. Can employers view participant information online?  Yes, employers have 24/7 web access and can see when a letter was mailed to a certain participant, check the status of the participant's payment, view reports, etc.
  4. Do you accept credit card payments for the monthly premiums?  Yes, BenefitsAssist, inc. allows participants to pay their premiums with either MasterCard or Visa.  There is a 4% convenience fee added to the premium.
  5. How long can I keep COBRA coverage?
    • Termination, Reduction in hours - 18 months

    • Divorce, separation - 36 months

    • Ineligible dependents - 36 months

    • Employee death - 36 months

    • Disability with Social Security letter - 29 months

Flexible Benefits Administration

FSA

  1. Am I as the employer eligible to set up this type of plan?  Sole proprietors, partners, members, and shareholders > 2% ownership of S corporations (and their family) cannot participate on a pre-tax basis in a Section 125 plan (including Premium Payment, Health FSA, Dependent Care FSA, and HSA).  But the plan can be created to benefit the employees of such organizations.
  2. Does the plan run on a calendar year such as January through December?  Plans run on a 12-month basis chosen by the employer.  Most plans coordinate with either the calendar year or the year of the health plan renewal or the health plan deductible year.
  3. Does the employer issue a check to BenefitsAssist, inc. for the FSA payroll deductions?  No.  The employer keeps all FSA payroll deductions.
  4. What services are included? Services include manual claim reimbursement by check or direct deposit.  We process claims bi-weekly (every 2 weeks).  If employers choose the debit card then the card is included.  Employers are informed of applicable Section 125 changes in regulations.
  5. Are employees allowed to go back and claim prior expenses before the plan went into effect?  No. 
  6. How do employees file manual claims?  Employees submit a claim form via fax, e-mail, or mail along with copies of the insurance carrier’s Explanation of Benefits or provider's invoice forms showing:  Employee or dependent name, Provider name, Date of service, Description of service, and Charge.  We cannot accept cancelled checks, credit/debit card receipts, non-itemized cash register receipts, previous balance statements, balance forward statements, or claims for future services.
  7. Is there a way to submit manual claims online? Employees can use the Participant Portal to submit claims online.
  8. What are the date ranges for valid claims?  The date of service must be between the employee’s plan year enrollment date and the plan year end date.  For terminated participants, the date of service must be between the plan year enrollment date and the termination date.
  9. Can a participant claim more than what has been deducted through payroll?  For Health FSAs the law requires that a person be reimbursed up to the amount of the election regardless of if the payroll deductions have taken place.  This means that a person can claim more than what was payroll deducted. For Dependent Care FSAs the law only requires reimbursement up the year-to-date payroll deduction amount at the time the claim is made.
  10. Does the employee submit the claim to BenefitsAssist, inc.?  Not to the employer?  The employee submits manual claims to BenefitsAssist, inc.
  11. How are often are manual claims reimbursed?  Is it check or direct deposit?  Claims received by the previous Thursday are included in the bi-weekly Monday claims process (if that Monday is a holiday the claims are processed the following business day).  We will issue a check or direct deposit based on the employee’s choice.
  12. How does the debit card work?  The FSA debit card is a MasterCard that can be used at valid health related merchants such as doctor’s offices, pharmacies, etc.  Employees must keep receipts and other documentation to prove the expense was eligible.  If the card swipe matches an employer co-pay then the employee may not have to submit documentation to BenefitsAssist, inc.  Otherwise, the employee will receive an e-mail requesting documentation validating that the purchase is eligible for the FSA.
  13. What is the claims filing deadline?  The claims filing deadline is the earlier of 90 days after termination or 90 days after plan year end.  Any unused funds are forfeited back to the plan.
  14. What happens if an employee terminates mid-year from the plan?  Employers should collect and destroy any Health FSA cards.  Payroll deductions should continue to the date of termination.  Participants can file manual claims for up to 90 days after termination but the date of service cannot be after the termination date.  If the participant has overdrawn the Health FSA account (see Question #9) the employer is not permitted to accept payment or initiate extra payroll deductions to cover the difference.  The employer can use plan forfeitures to offset the risk of a person overdrawing the Health FSA.
  15. How is BenefitsAssist, inc. reimbursed for the FSA claims paid by BenefitsAssist, inc.?  BenefitsAssist, inc. drafts the employer’s bank account shortly after it has processed bi-weekly manual claims.  Debit card charges are drafted from the employer bank account on a daily basis.
  16. Can employees view their accounts online? Employees can login and view their account online.
  17. What reports are included?  The following reports are e-mailed to the employer: Bi-weekly manual claims report, Daily card charge report, and Monthly account report.
  18. Is there an annual fee?  BenefitsAssist, inc. currently does not charge an annual maintenance fee.  If the Employer wishes for BenefitsAssist, inc. to perform discrimination testing on the plan the charge is $125/hr and usually takes 1-2 hours.  If the employer wishes BenefitsAssist, inc. to prepare a draft Form 5500 the fee is $125/hour with a minimum of $300 per Form 5500.
  19. How do fees work if the employer is implementing BOTH a Section 125 FSA and an HRA?  The Document creation fee is charged separately at $300 each for the Section 125 plan and HRA plan since they are separate written plans.  The Setup fee is charged once at $200 per Employer since the fee covers getting employees into the system.  The Administration and Debit card fee for Health FSA, Dependent Care FSA, and HRA is charged once per employee not per account.  So an employee can have multiple FSA and/or HRA accounts and the employer is billed the quoted per employee per month charge.
  20. How do fees work if the employer is implementing BOTH a Section 125 FSA and an HSA?  The Document creation fee is charged once at $300 since it is one written Section 125 plan.  Instead of paying two Setup fees at $200 each the total Setup fee to cover both FSA and HSA is $300.  The Administration and Debit card fees are per the FSA and HSA proposals.   

HRA

  1. Am I as the employer eligible to set up this type of plan?  Sole proprietors, partners, members, and shareholders > 2% ownership of S corporations (and their family) cannot participate on a pre-tax basis in a Health Reimbursement Arrangement (HRA).  But the plan can be created to benefit the employees of such organizations.
  2. Does the plan run on a calendar year such as January through December?  Plans run on a 12-month basis chosen by the employer.  Most plans coordinate with the health plan deductible year.
  3. What services are included? Services include manual claim reimbursement by check or direct deposit.  We process claims bi-weekly (every 2 weeks).  If employers choose the debit card then the card is included.  Employers are informed of applicable HRA changes in regulations.
  4. Are employees allowed to go back and claim prior expenses before the plan went into effect?  No.
  5. How do employees file manual claims?  Employees submit a claim form via fax, e-mail, or mail along with copies of the insurance carrier’s Explanation of Benefits or provider's invoice forms showing:  Employee or dependent name, Provider name, Date of service, Description of service, and Charge.  We cannot accept cancelled checks, credit/debit card receipts, non-itemized cash register receipts, previous balance statements, balance forward statements, or claims for future services. 
  6. Is there a way to submit manual claims online? Employees can use the Participant Portal to submit claims online.
  7. What are the date ranges for valid claims?  The date of service must be between the employee’s plan year enrollment date and the plan year end date.  For terminated participants, the date of service must be between the plan year enrollment date and the termination date.
  8. Does the employee submit the claim to BenefitsAssist, inc.?  Not to the employer?  The employee submits manual claims to BenefitsAssist, inc.
  9. How are often are manual claims reimbursed?  Is it check or direct deposit?  Claims received by the previous Thursday are included in the bi-weekly Monday claims process (if that Monday is a holiday the claims are processed the following business day).  We will issue a check or direct deposit based on the employee’s choice.
  10. How does the debit card work?  The HRA debit card is a MasterCard that can be used at valid health related merchants such as doctor’s offices, pharmacies, etc.  Employees must keep receipts and other documentation to prove the expense was eligible.  If the card swipe matches an employer co-pay then the employee may not have to submit documentation to BenefitsAssist, inc.  Otherwise, the employee will receive an e-mail requesting documentation validating that the purchase is eligible for the HRA.
  11. What is the claims filing deadline?  The claims filing deadline is the earlier of 90 days after termination or 90 days after plan year end.
  12. What happens if an employee terminates mid-year from the plan?  Employers should collect and destroy any Health HRA cards.  Participants can file manual claims for up to 90 days after termination but the date of service cannot be after the termination date.
  13. How is BenefitsAssist, inc. reimbursed for the HRA claims paid by BenefitsAssist, inc.?  BenefitsAssist, inc. drafts the employer’s bank account shortly after it has processed bi-weekly manual claims.  Debit card charges are drafted from the employer bank account on a daily basis.
  14. Can employees view their accounts online? Employees can login and view their account online.
  15. What reports are included?  The following reports are e-mailed to the employer: Bi-weekly manual claims report, Daily card charge report, and Monthly account report.
  16. Is there an annual fee?  BenefitsAssist, inc. currently does not charge an annual maintenance fee.  If the Employer wishes for BenefitsAssist, inc. to perform discrimination testing on the plan the charge is $125/hr and usually takes 1-2 hours.  If the employer wishes BenefitsAssist, inc. to prepare a draft Form 5500 the fee is $125/hour with a minimum of $300 per Form 5500.   
  17. How do fees work if the employer is implementing BOTH a Section 125 FSA and an HRA?  The Document creation fee is charged separately at $300 each for the Section 125 plan and HRA plan since they are separate written plans.  The Setup fee is charged once at $200 per Employer since the fee covers getting employees into the system.  The Administration fee and Debit card fee for Health FSA, Dependent Care FSA, and HRA is charged once per employee not per account.  So an employee can have multiple FSA and/or HRA accounts and the employer is billed the quoted per employee per month charge.