HRA Employer Guide May 2015

Size: px
Start display at page:

Download "HRA Employer Guide May 2015"

Transcription

1 HRA Employer Guide May 2015

2 Welcome As the leading administrator for Health Reimbursement Arrangements (HRAs), BenefitWallet provides administrative services to you and your employees. This employer guide should be used as a resource to understand your BlueFund HRA plan offered through CareFirst BlueCross BlueShield (CareFirst). What do you need to do now? 1. Review this employer guide. You also have access to BenefitWallet s dedicated Employer Support Team at and a website to assist you in administering your HRA and funding process. 2. Complete and return the HRA Set-Up Form and ACH Authorization Form by fax to or by to employersetup@mybenefitwallet.com. 3. A 3-digit employer ID will be assigned to your group. The individual designated as the primary business contact will receive s with: 1) a security challenge form to authenticate speaking with the Employer Support Team; 2) web login instructions (including your temporary password). If you need this information resent, please contact the Employer Support Team. 4. Review the online Participant Account Report to verify the processing of your group s eligibility information. 5. Once enrollment is loaded, you will receive an with your Required Minimum Funding (RMF) amount. Refer to the Account Funding section for more detail on RMF. Table of Contents What do you need to do now?... 1 Employer role with HRAs COBRA Notification Process... 2 Security... 2 Enrollment process... 2 Account funding... 3 Contribution approval... 3 Claims processing authority... 3 Claims payment process... 4 HRA payment services... 4 Employer website... 5 Reporting... 5 Contacts... 6 Holiday schedule... 6 Employer role with HRAs To assist in the establishment and administration of employees HRAs, you will be required to provide certain documents, instructions and information. Please note that a delay in submitting the necessary materials could result in a delay of HRA services or prevent BenefitWallet from providing HRA administration. You are responsible for: Ensuring your HRA complies with all applicable provisions of the Internal Revenue Code and any applicable state and local laws. Ensuring that the summary plan description, plan document and any other documentation relating to the HRA are appropriately completed, in compliance with, and maintained in compliance with, the requirements of applicable law and are appropriately and timely adopted. Distributing summary plan descriptions, summaries of material modification and any other documentation with respect to the HRA to participants on a timely basis. 1

3 Filing documentation with the appropriate government agencies, including the Department of Labor and the Internal Revenue Service. COBRA notification process The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows participants to continue their health plan benefits upon termination of employment. If the employer is subject to COBRA, they must offer the participant the opportunity to continue their HRA coverage. However, if the participant does not elect the HRA coverage the employer must notify BenefitWallet immediately to prevent any further claim payouts. If the employer fails to provide proper notification, BenefitWallet will not be responsible for claim payments that are not returned. Security The security of information provided by you and your employees is of paramount concern to BenefitWallet. Each call to our service center is authenticated to ensure information is provided only to authorized contacts. Employer authentication is based on the contact list provided during setup, coupled with the responses to selected security challenge questions. Only indicated, authorized contacts who respond correctly to the recorded questions may discuss employer information. An integral part of security concerns include communications/transmissions and the submission of data. All funding occurs via an ACH pull initiated by BenefitWallet. In the rare instance when an requires employer or employee personal information (see list below), the should be sent using a secure link (i.e. Tumbleweed, Secure Message) or as a Pretty Good Privacy (PGP) encrypted . Employers may obtain a PGP encrypted valid for six weeks from the Employer Support Team. Personal information includes: Name Address and/or zip code address Telephone number Dates (including date of birth or effective date) Account number Tax ID or Social Security Number Enrollment process You are responsible for determining which employees are eligible to participate in the HRA. Once this information is available, BenefitWallet will need: A complete list of those eligible employees, either provided directly or through your health plan Any demographic or other information related to those eligible employees that BenefitWallet may need to administer the HRA Notification directly, or through your health plan, of any changes in employee eligibility information (at least monthly) To modify an employee s HRA eligibility or status, you must provide both the effective and termination date of eligibility prior to the effective date of such changes. 2

4 Late notification of HRA eligibility or incorrect eligibility information may result in erroneous benefit claim payments. You will be responsible for any erroneous benefit payments (including the collection of any erroneous payments from the individual) that occur because of late or incorrect eligibility information provided by you or by a third party on your behalf. Once an HRA is set up, indicative data changes may ONLY be made by the employee. Employees can make these changes on the member website or by calling the BenefitWallet Customer Service Center. Account funding HRAs are notional accounts that require a minimum level of pre-funding by the employer. The HRA funding process requires you to: Advance benefit payments on behalf of the HRA by transferring funds from your general assets to the HRA in an amount equal to 10% of expected annual HRA benefit payments (also known as the required minimum funding amount). There is a required minimum funding amount of $250. Make the initial required minimum funding deposit prior to the effective date of the initial HRA plan year. An invoice will be sent and funds in the amount of the RMF will be pulled via ACH from your designated employer account one to two weeks prior to the plan effective date. Complete and return the employer ACH Authorization Form. Weekly transfer: BenefitWallet will initiate a transfer via ACH from your designated bank account on a weekly basis. Each week, we will send an invoice via and initiate an ACH to transfer an amount equal to that week s claims. The amount transferred will be the amount necessary to return the existing deposit balance to the required minimum funding amount. Monthly transfer: BenefitWallet will recalculate the required minimum funding amount based on the expected annual HRA enrollments on a monthly basis for all of your HRA participants active at that time. If the recalculated required minimum funding amount exceeds the previous required minimum funding by 25% or more, the previous required minimum funding amount will be replaced by the new calculation. Conversely, on a quarterly basis if the re-calculated RMF amount is less than the current RMF by 25%, we will manually refund the overage. Authorize BenefitWallet to write checks for the payment of allowable HRA claims. NOTE: BenefitWallet will not issue claim payments of any kind or approve debit card payments if the existing deposit balance falls below $0.00. Contribution approval Contribution approval is ONLY required for HRAs when funds are available to employees on a cycle (e.g. weekly or quarterly) and an employer is funding the HRAs throughout the year. When contributions are scheduled to be made, employers must approve the contribution amounts prior to each contribution cycle. In order for funds to be applied to employees accounts, approvals must be completed by logging onto the HRA employer portal at Contribution approval requirements: The contribution approval process is required for both initial and ongoing funding. Do not forget to approve contributions for the initial funding of accounts. Contribution approval timing: Contribution invoices are posted on the Employer Dashboard for your approval approximately three days before the contribution date. It s a good idea to schedule a reminder on your calendar. Once HRA contribution amounts are approved, funds typically appear in employees accounts the next business day. Contribution approval is NOT required for HRAs that provide the full contribution amount to employees on the first day of the plan year (uniform coverage). Claims processing authority The employer is the plan administrator of the HRA as described under ERISA. BenefitWallet is not authorized to waive, alter or modify any terms or conditions of the HRA. Both the employer and BenefitWallet are claims fiduciaries of the HRA, as that term is used under ERISA, with respect to the following activities: 3

5 BenefitWallet will determine whether an HRA expense is qualified under the Internal Revenue Code and regulations thereunder, and any IRS written rulings, notices and advisories. BenefitWallet will make payments or distributions based on the framework of policies, interpretations, rules, practices and procedures provided for in your HRA plan documents and as otherwise agreed upon or directed by you. BenefitWallet (including its subcontractors) will not have any discretion, control or authority with respect to benefit determinations. You retain the authority to decide appeals. Claims payment process BenefitWallet will process claims within three business days of the date they receive a claim request from a participant. Checks, if applicable, will be issued within two scheduled daily check payment cycles, upon receipt of claims in good order. Claims are in good order when the reimbursement request contains all pertinent information, including information required to substantiate the claim. If the participant does not have sufficient funds in his/her HRA at the time the claim is submitted, the reimbursement request will be held and processed in accordance with the time frame described above, starting with the date that such funds are available. If a participant is not able to substantiate a claim or if a debit card payment is subsequently deemed ineligible for reimbursement, BenefitWallet will attempt to collect these amounts from the participant. If BenefitWallet is unsuccessful collecting these amounts, you will be responsible for collecting such amounts. BenefitWallet will make data available to you that identifies the participant and the unsubstantiated or ineligible reimbursement amount. BenefitWallet will not provide or negotiate for refunds of unused services or unneeded items and is not responsible for determining whether a participant received a cash refund from a merchant or provider for items or services originally purchased or paid for using the debit card. HRA payment services BenefitWallet offers the following payment services: Debit card services allow a participant s account balance to automatically transfer to a debit card integrated with the participant s account. The debit card can be used at any eligible merchant provided the merchant has properly configured the merchant code to identify itself correctly or is IIAS-compliant. Cardholders are subject to the terms and conditions described in the cardholder agreement, which is provided with the debit card. Employers decide whether or not to offer debit cards to their employees during the initial set up. Reimbursement services are made to participants via a check or direct deposit. Participants who do not have debit cards will be automatically reimbursed for any patient liability based on claims data provided by CareFirst. 4

6 Employer website You can access the employer website via The Employer Dashboard contains employee look-up information to resolve issues as well as Frequently Asked Questions. The individual designated as your primary business contact will receive logon information for this site. He/she may then set up sub-user IDs for other authenticated business contacts. Reporting BenefitWallet offers several reports to assist with your HRA plan administration. These reports are designed to show funding status, detailed participant information, and aggregate account information at the group level. Each report can easily be exported to Excel, CSV or XML, allowing employers to easily combine this data into any standard data management tool. The reports are organized into three categories: Employers needing assistance with their password should contact the Employer Support Team at Account balance and administrative reports Claims reports Funding and contribution reports Account balance and administrative reports Participant accounts: Provides details by employee of the election/benefit amount, claims paid, available balance and more. Utilization and forfeiture report: Displays employees remaining account balance and other account details after the end of the plan year and run-out period. This report differs from the savings account forfeitures report, which displays only accounts that have gone through the forfeiture process and subsequently have $0.00 balances. Group audit report: Shows a snapshot of your group s setup, including business contacts, plan design, contribution information, copays and funding. Employers should periodically review this audit report. Claims reports Weekly claims detail report: Validates funding requests and lists all paid claims supporting the weekly invoices and ACH transfers. Rejected claims write off report: Allows employers to view employees ineligible claims that have been written off. Employers should refer to this report to determine which claims are unsubstantiated claims and therefore need to become taxable. Claims needing documentation report: Lists all claims that still need appropriate documentation, including health care payment card claims and reimbursement requests made online or through the mail. 5

7 Rejected claims requiring refunds report: Lists all claims that have been rejected or partially rejected. Reasons for rejection include ineligible expenses and dates of service outside the plan year parameters. These claims require a refund to the plan. Funding and contribution reports Contribution funding details report: Provides details on contributions, including amount, deduction date, etc. This report can be helpful if you are an employer who makes incremental contributions throughout the year. Contribution report: Provides a list of contributions for a particular employee. Use the following parameters to select the employee and the time period desired: Start date End date Social Security Number Contacts Your Employer Support Team is available Monday Friday from 8:00 a.m. to 8:00 p.m. EST at or employersetup@mybenefitwallet.com. Your employees also have access to a dedicated customer service department at , Monday Friday from 8:00 a.m. to 11:00 p.m. (EST). Holiday schedule BenefitWallet will be closed for the following holidays in 2015: New Year s Day: Thursday, January 1, 2015 Memorial Day: Monday, May 25, 2015 Fourth of July: Saturday, July 4, 2015 Labor Day: Monday, September 7, 2015 Thanksgiving Day: Thursday, November 26, 2015 Christmas Day: Friday, December 25, 2015 The following fields are displayed online and may be exported to Excel, CSV or XML files: Last name First name Social Security Number Employee ID Contribution date Invoice number Invoice type Contribution amount Contribution type Settle status Type CareFirst BlueCross BlueShield is an independent licensee of the Blue Cross and Blue Shield Association. Registered trademark of CareFirst of Maryland, Inc. BenefitWallet is a product owned by Xerox HR Solutions LLC, an independent company that is solely responsible for their products and will be providing services to CareFirst members. BenefitWallet does not sell BlueCross or BlueShield products Xerox HR Solutions, LLC. All rights reserved. CST2452-9E (5/15)

Alternate Payroll Process Health Savings Account HSA Employer Payroll Funding Application

Alternate Payroll Process Health Savings Account HSA Employer Payroll Funding Application Alternate Payroll Process Health Savings Account HSA Employer Payroll Funding Application August 2015 Version 2.2 Table of Contents Payroll Application Tab 3 Display 3 Contribution Information 5 Submitting

More information

Health Savings Account - HSA Employer Guide

Health Savings Account - HSA Employer Guide Health Savings Account - HSA Employer Guide August 2014 Table of Contents Welcome... 3 What Do You Need to Do Now?... 3 Employer Role With Respect to HSAs... 4 Security... 4 Fees and Billing... 4 Enrollment

More information

Dependent Care flexible spending account (FSA) administered through Kaiser Permanente

Dependent Care flexible spending account (FSA) administered through Kaiser Permanente Dependent Care flexible spending account (FSA) administered through Kaiser Permanente Funds from a Dependent Care flexible spending account (FSA) can be used to pay for any qualified expenses as defined

More information

CONSUMER ONLINE BANKING DISCLOSURE AND AGREEEMENT

CONSUMER ONLINE BANKING DISCLOSURE AND AGREEEMENT CONSUMER ONLINE BANKING DISCLOSURE AND AGREEEMENT This Agreement describes your rights and obligations as a user of the Online Banking service and/or the Bill Payment and Presentment service ("Services").

More information

Frequently Asked Questions for HSAs (Health Savings Accounts)

Frequently Asked Questions for HSAs (Health Savings Accounts) Frequently Asked Questions for HSAs (Health Savings Accounts) (Rev July 2015) HOW A HEALTH SAVINGS ACCOUNT (HSA) WORKS Q: What is an HSA and how does it work? A: If you elect the PPO Plus HSA Plan (new

More information

Health Savings Account (HSA) Member Guide. 2014 Xerox HR Solutions, LLC. All rights reserved.

Health Savings Account (HSA) Member Guide. 2014 Xerox HR Solutions, LLC. All rights reserved. Health Savings Account (HSA) Member Guide 2014 Xerox HR Solutions, LLC. All rights reserved. Table of contents Welcome to the BenefitWallet HSA!... 3 What is a Health Savings Account (HSA)?...3 Your BenefitWallet

More information

HSA EMPLOYER RESOURCE GUIDE. Fifth Third Bank Health Savings Account Revision 3

HSA EMPLOYER RESOURCE GUIDE. Fifth Third Bank Health Savings Account Revision 3 HSA EMPLOYER RESOURCE GUIDE Fifth Third Bank Health Savings Account Revision 3 CONTENTS Welcome... 3 About Your HSA... 4 Benefits to You... 4 Benefits to Your Employees... 4 Your HSA Implementation Checklist...

More information

Hanover EZPay Policyholder Guide & Frequently Asked Questions

Hanover EZPay Policyholder Guide & Frequently Asked Questions Hanover Commercial Lines Hanover EZPay Policyholder Guide & Frequently Asked Questions Getting Started Setting up Hanover EZPay is quick and easy. The Hanover EZPay portal features user-friendly screens

More information

Health Savings Account

Health Savings Account Health Savings Account (HSA) Solutions Release yourself from complicated account administration ConnectYourCare is the industry s leading HSA expert, they are partnering with Baptist Health Plan to navigate

More information

FREQUENTLY ASKED QUESTIONS ABOUT THE FSA DEBIT CARD

FREQUENTLY ASKED QUESTIONS ABOUT THE FSA DEBIT CARD FREQUENTLY ASKED QUESTIONS ABOUT THE FSA DEBIT CARD How does the FSA Debit Card factor in? If you participated in the Flexible Spending Plan last plan year, you will not receive a new card for the current

More information

PayFlex HealthHub TM Health Savings Account Set Up Portal Guide

PayFlex HealthHub TM Health Savings Account Set Up Portal Guide PayFlex HealthHub TM Health Savings Account Set Up Portal Guide PRESENTED BY: 10802 Farnam Drive, Suite 100 Omaha, Nebraska 68154 (800) 284-4885 TABLE OF CONTENTS PAYFLEX ACADEMY Section 1 HSA Requirements...

More information

GLOBAL EXPRESS PAYMENT CENTER

GLOBAL EXPRESS PAYMENT CENTER GLOBAL EXPRESS PAYMENT CENTER USER GUIDE V1.4 EFFECTIVE 05/14/15 TABLE OF CONTENTS 03 Get Started Set Up Terminal Required Step by Admin Set Up Users Required Step by Admin Set Up Receipt Explore Dashboard

More information

FREQUENTLY ASKED QUESTIONS QUALIFIED HIGH DEDUCTIBLE HEALTH PLAN WITH A HEALTH SAVINGS ACCOUNT

FREQUENTLY ASKED QUESTIONS QUALIFIED HIGH DEDUCTIBLE HEALTH PLAN WITH A HEALTH SAVINGS ACCOUNT FREQUENTLY ASKED QUESTIONS QUALIFIED HIGH DEDUCTIBLE HEALTH PLAN WITH A HEALTH SAVINGS ACCOUNT Qualified High Deductible Health Plans (QHDHP) What is a QHDHP? A QHDHP is a medical plan regulated by the

More information

COBRA ADMINISTRATIVE SERVICES AGREEMENT

COBRA ADMINISTRATIVE SERVICES AGREEMENT COBRA ADMINISTRATIVE SERVICES AGREEMENT This Administrative Services Agreement ( Agreement ) is hereby made between Providence Health Plan ( Providence ) and the Employer ( Employer ) and applies to all

More information

FREQUENTLY ASKED QUESTIONS ID CARDS / ELIGIBILITY / ENROLLMENT

FREQUENTLY ASKED QUESTIONS ID CARDS / ELIGIBILITY / ENROLLMENT FREQUENTLY ASKED QUESTIONS ID CARDS / ELIGIBILITY / ENROLLMENT BENEFIT INFORMATION CLAIMS STATUS/INFORMATION GENERAL INFORMATION PROVIDERS THE SIGNATURE 90 ACCOUNT PLAN THE SIGNATURE 80 PLAN USING YOUR

More information

Only checking accounts can be used for Bill Payment purposes.

Only checking accounts can be used for Bill Payment purposes. INTERNET BILL PAYMENT SERVICE AGREEMENT The Internet Bill Payment service allows you to pay your bills electronically through a personal computer, rather than manually writing and mailing checks. You can

More information

Health Savings Account (HSA)

Health Savings Account (HSA) Tax-Advantaged Accounts Health Savings Account (HSA) September 8, 2015 State of Tennessee Local Education & Local Government Today s presentation will cover: Health Savings Account (HSA) Eligibility and

More information

WASHINGTON STATE EMPLOYEES CREDIT UNION ONLINE BANKING AGREEMENT BUSINESS ACCOUNTS

WASHINGTON STATE EMPLOYEES CREDIT UNION ONLINE BANKING AGREEMENT BUSINESS ACCOUNTS WASHINGTON STATE EMPLOYEES CREDIT UNION ONLINE BANKING AGREEMENT BUSINESS ACCOUNTS This Agreement is the contract which covers your and our rights and responsibilities concerning Online Banking services

More information

Direct FLEXIBLE SPENDING ACCOUNT (FSA) PLAN DESIGN GUIDE. For Office Use Only SelectAccount Group Number Enrollment Specialist Market Segment

Direct FLEXIBLE SPENDING ACCOUNT (FSA) PLAN DESIGN GUIDE. For Office Use Only SelectAccount Group Number Enrollment Specialist Market Segment I. EMPLOYER INFORMATION Direct FLEXIBLE SPENDING ACCOUNT (FSA) PLAN DESIGN GUIDE Employer s Name Employer s Street Address City State Zip Code Employer s Tax I.D. Number (required) Type of Corporation

More information

A SMART WAY TO PAY. AN EASY WAY TO SAVE. Fifth Third Bank Health Savings Account

A SMART WAY TO PAY. AN EASY WAY TO SAVE. Fifth Third Bank Health Savings Account A SMART WAY TO PAY. AN EASY WAY TO SAVE. Fifth Third Bank Health Savings Account Contents Welcome 3 Getting Started 4 Logging in for the First Time 4 Forget your Username or Password? 4 Home Page 5 Make

More information

Flexible Spending Account Employee Guide

Flexible Spending Account Employee Guide WHAT IS A FLEXIBLE SPENDING ACCOUNT (FSA)? A Flexible Spending Account, sometimes referred to as a Section 125 Plan, is a company-sponsored program, which allows you to voluntarily set aside pre-tax dollars

More information

Home Trust & Savings Bank www.hometrustbank.com

Home Trust & Savings Bank www.hometrustbank.com Home Trust & Savings Bank www.hometrustbank.com Terms & Conditions Please read the following Electronic Banking Agreement before you sign the enrollment form. GENERAL TERMS This agreement (the Agreement

More information

BUSINESS ONLINE BANKING AGREEMENT

BUSINESS ONLINE BANKING AGREEMENT BUSINESS ONLINE BANKING AGREEMENT This Business Online Banking Agreement ("Agreement") establishes the terms and conditions for Business Online Banking Services ( Service(s) ) provided by Mechanics Bank

More information

Instruction Guide. People First Dependent Certification Process

Instruction Guide. People First Dependent Certification Process People First Dependent Certification Process Each time an employee logs into People First to make an enrollment selection during open enrollment or because of a qualified status change (QSC), he/she must

More information

Treasury Management Services Product Terms and Conditions

Treasury Management Services Product Terms and Conditions Treasury Management Services Product Thank you for choosing M&T Bank for your treasury management service needs. We appreciate the opportunity to serve you. If you have any questions about this Product

More information

User Guide. COBRA Employer Manual

User Guide. COBRA Employer Manual Experience Excellence COBRA Manual User Guide COBRA Employer Manual COBRA Responsibilities and Deadlines Under COBRA, specific notices must be provided to covered employees and their families explaining

More information

Health Savings Account Administration Instructions

Health Savings Account Administration Instructions 475 14 th Street, Suite 650 Oakland, CA 94612 P.O. Box 71107 Oakland, CA 94612 T: 1.800.617.4729 F: 1.877.517.4729 Health Savings Account Administration Instructions No Plan Document is needed for Healthcare

More information

COBRA & Billing Administration Administration Services Guide. Welcome!

COBRA & Billing Administration Administration Services Guide. Welcome! Welcome! V4.4/2009 Table of Contents: Welcome Message COBRA & Billing Administrator Contact Information COBRA & Billing Administration Overview COBRA Administration Functions Procedures for Full COBRA

More information

Health Reimbursement Account (HRA) Frequently Asked Questions

Health Reimbursement Account (HRA) Frequently Asked Questions Health Reimbursement Account (HRA) Frequently Asked Questions Q. What is a Health Reimbursement Account (HRA)? A. A Health Reimbursement Account (HRA) is part of the benefit plan offered to you by Brookhaven

More information

FLEXIBLE SPENDING ACCOUNT (FSA) PLAN DESIGN GUIDE

FLEXIBLE SPENDING ACCOUNT (FSA) PLAN DESIGN GUIDE FLEXIBLE SPENDING ACCOUNT (FSA) PLAN DESIGN GUIDE Please complete this form and return to SelectAccount 45 days before your effective date so we can properly administer your plan. If you have any questions,

More information

SALEM FIVE ONLINE BANKING AGREEMENT

SALEM FIVE ONLINE BANKING AGREEMENT SALEM FIVE ONLINE BANKING AGREEMENT What This Agreement Covers This agreement (the Agreement ) between you and Salem Five Cents Savings Bank ( we, our, us, or Salem Five ) governs your use of Salem Five

More information

ONLINE BANKING DISCLOSURE/AGREEMENT

ONLINE BANKING DISCLOSURE/AGREEMENT ONLINE BANKING DISCLOSURE/AGREEMENT Rev 4/10 YOUR ACCEPTANCE OF THESE TERMS OF USE - ONLINE BANKING ("ONLINE BANKING TERMS") Meridian Bank requires all visitors who access its Online Banking to follow

More information

WELCOME TO THE AETNA HEALTHFUND HEALTH SAVINGS ACCOUNT (HSA)

WELCOME TO THE AETNA HEALTHFUND HEALTH SAVINGS ACCOUNT (HSA) WELCOME TO THE AETNA HEALTHFUND HEALTH SAVINGS ACCOUNT (HSA) Welcome to the Aetna HealthFund Health Savings Account (HSA). We know how important your employees are to you, and we want to work with you

More information

SAMPLE FSA KIT. Did you know that Flexible Spending Accounts can help you save on your health care and dependent care costs?

SAMPLE FSA KIT. Did you know that Flexible Spending Accounts can help you save on your health care and dependent care costs? Did you know that Flexible Spending Accounts can help you save on your health care and dependent care costs? It s true! Having money in a Flexible Spending Account (FSA) is like having money in the bank

More information

Self-Administrative Manual. Self- Administration Manual

Self-Administrative Manual. Self- Administration Manual Self- Administration 1 Welcome Dear Valued Customer: Thank you for choosing DirectPay as Administrator of your Direct Reimbursement Self Administration Plan. We appreciate your business and look forward

More information

msb@home Montezuma State Bank Internet Banking Agreement www.montestbk.com Online banking is not available to children under 18 years of age.

msb@home Montezuma State Bank Internet Banking Agreement www.montestbk.com Online banking is not available to children under 18 years of age. msb@home Montezuma State Bank Internet Banking Agreement www.montestbk.com Online banking is not available to children under 18 years of age. General Terms This agreement (the Agreement ) made between

More information

The Wells Fargo Payment Gateway Business Center. User Guide

The Wells Fargo Payment Gateway Business Center. User Guide The Wells Fargo Payment Gateway Business Center User Guide Contents 1 Introduction 1 About the Wells Fargo Payment Gateway service Business Center 1 About this guide 2 Access the Business Center 2 Log

More information

Online Banking - Terms and Conditions

Online Banking - Terms and Conditions Online Banking - Terms and Conditions (updated 12/2015) Welcome to electronic banking at Capstone Bank. This Agreement and Disclosure Statement for Online Banking Services (the "Agreement") describes the

More information

WASHINGTON STATE EMPLOYEES CREDIT UNION ONLINE BANKING AGREEMENT

WASHINGTON STATE EMPLOYEES CREDIT UNION ONLINE BANKING AGREEMENT WASHINGTON STATE EMPLOYEES CREDIT UNION ONLINE BANKING AGREEMENT This Agreement is the contract which covers your and our rights and responsibilities concerning Online Banking services ("Online Banking")

More information

Follow these easy steps to apply for an account by mail:

Follow these easy steps to apply for an account by mail: Follow these easy steps to apply for an account by mail: 1. All information is required unless otherwise indicated. Federal law requires all financial institutions to obtain, verify, and record information

More information

We encourage you to keep this Agreement for your records. If you have any questions, please contact a Customer Service Representative.

We encourage you to keep this Agreement for your records. If you have any questions, please contact a Customer Service Representative. Internet Banking Terms and Conditions Agreement This Agreement describes your rights and obligations as a user of the Internet Banking Service or the Bill Payment Service ("Service" or "Services"). It

More information

FIRST GENERAL CREDIT UNION ONLINE BANKING AND BILL PAYMENT AGREEMENT

FIRST GENERAL CREDIT UNION ONLINE BANKING AND BILL PAYMENT AGREEMENT FIRST GENERAL CREDIT UNION ONLINE BANKING AND BILL PAYMENT AGREEMENT This Agreement describes your rights and obligations as a user of the Online Banking service and/or the Bill Payment service (collectively

More information

Health Reimbursement Account (HRA) Frequently Asked Questions (FAQ)

Health Reimbursement Account (HRA) Frequently Asked Questions (FAQ) Health Reimbursement Account (HRA) Frequently Asked Questions (FAQ) What is a Health Reimbursement Account (HRA)? The HRA is an employer-sponsored plan that can be used to reimburse a portion of you and

More information

Federally Insured Cash Account. FICA Program Terms and Conditions

Federally Insured Cash Account. FICA Program Terms and Conditions Federally Insured Cash Account FICA Program Terms and Conditions November 2012 Federally Insured Cash Account I. Introduction The FICA Program offered by StoneCastle Cash Management, LLC ( StoneCastle

More information

An independent licensee of the Blue Cross and Blue Shield Association GROUP CONTRACT APPLICATION GENERAL INFORMATION.

An independent licensee of the Blue Cross and Blue Shield Association GROUP CONTRACT APPLICATION GENERAL INFORMATION. Group Hospitalization and Medical Services, Inc. doing business as CareFirst BlueCross BlueShield (CareFirst) 840 First Street, NE Washington, D.C. 20065 202-479-8000 An independent licensee of the Blue

More information

COCA-COLA ENTERPRISES, INC. DIVIDEND REINVESTMENT AND CASH INVESTMENT PLAN

COCA-COLA ENTERPRISES, INC. DIVIDEND REINVESTMENT AND CASH INVESTMENT PLAN COCA-COLA ENTERPRISES, INC. DIVIDEND REINVESTMENT AND CASH INVESTMENT PLAN TABLE OF CONTENTS Principal Features of the Plan 1 How to Enroll in the Plan 1 How to Complete the Enrollment Authorization Form

More information

EagleBank Online Service Agreement and Electronic Funds Transfer Disclosure

EagleBank Online Service Agreement and Electronic Funds Transfer Disclosure EagleBank Online Service Agreement and Electronic Funds Transfer Disclosure No one from EagleBank will ever contact you in any form (fax, letter, email, phone call, etc.) and ask you to provide your online

More information

MUTUAL S ONLINE BANKING & BILL PAYMENT AGREEMENT

MUTUAL S ONLINE BANKING & BILL PAYMENT AGREEMENT MUTUAL S ONLINE BANKING & BILL PAYMENT AGREEMENT This Agreement describes your rights and obligations as a user of the Online Banking Service or the Bill Payment Service ("Services"). It also describes

More information

Health Services provider user guide

Health Services provider user guide Health Services provider user guide online claims submission... convenient service, delivered through an easy-to-use secure web site http://provider.ab.bluecross.ca/health... convenient service, delivered

More information

ELECTRONIC VALUE TRANSFER CONTRACT (EVT) CREDIT CARD SETTLEMENT

ELECTRONIC VALUE TRANSFER CONTRACT (EVT) CREDIT CARD SETTLEMENT ELECTRONIC VALUE TRANSFER CONTRACT (EVT) CREDIT CARD SETTLEMENT Credit card settlement is the process by which authorized transactions are submitted to card issuers for payment. Unlike authorization, which

More information

Business Online Bill Pay Terms and Conditions

Business Online Bill Pay Terms and Conditions Business Online Bill Pay Terms and Conditions This Online Bill Pay Terms and Conditions ("Agreement") is between Customer and Spring Bank for the delivery of Business Online Bill Pay as described below:

More information

Health Reimbursement Arrangement Frequently Asked Questions

Health Reimbursement Arrangement Frequently Asked Questions Health Reimbursement Arrangement Frequently Asked Questions What is a Health Reimbursement Arrangement (HRA)? The HRA is an employer-funded health care reimbursement account. The employee incurs eligible

More information

Treasury Management Guide to ACH Origination Processing and Customer Service March 2012

Treasury Management Guide to ACH Origination Processing and Customer Service March 2012 Treasury Management Guide to ACH Origination Processing and Customer Service March 2012 This guide provides important information regarding ACH origination processing at PNC and addresses many frequently

More information

Mobile Check Capture Service

Mobile Check Capture Service Mobile Check Capture Service Mobile Check Capture Deposit Service allows you to use the camera on your mobile device to take a picture of a check and deposit it into your account at Christian Financial

More information

SnoPAY FREQUENTLY ASKED QUESTIONS

SnoPAY FREQUENTLY ASKED QUESTIONS SnoPAY FREQUENTLY ASKED QUESTIONS GENERAL QUESTIONS What is SnoPAY? SnoPAY allows you to view and pay your bills anywhere you have Internet access anytime you want, within the United States and Canada.

More information

Online Bill Pay User Manual

Online Bill Pay User Manual \ Online Bill Pay User Manual Updated: November 14, 2014 Page 1 Table of Contents I. Welcome to Online Bill Pay... 3 II. New User Registration... 4 III. Login for Registered Users... 7 IV. Home Page Functionality...

More information

SnoPAY FREQUENTLY ASKED QUESTIONS

SnoPAY FREQUENTLY ASKED QUESTIONS SnoPAY FREQUENTLY ASKED QUESTIONS GENERAL QUESTIONS What is SnoPAY? SnoPAY allows you to view and pay your bills anywhere you have Internet access anytime you want. You can pay by transferring money directly

More information

TRUCHOICE FEDERAL CREDIT UNION CONSENT FOR ELECTRONIC DISCLOSURES UNDER THE ELECTRONIC SIGNATURES IN GLOBAL AND NATIONAL COMMERCE ACT

TRUCHOICE FEDERAL CREDIT UNION CONSENT FOR ELECTRONIC DISCLOSURES UNDER THE ELECTRONIC SIGNATURES IN GLOBAL AND NATIONAL COMMERCE ACT TRUCHOICE FEDERAL CREDIT UNION CONSENT FOR ELECTRONIC DISCLOSURES UNDER THE ELECTRONIC SIGNATURES IN GLOBAL AND NATIONAL COMMERCE ACT Please read this information carefully and print a copy and/or retain

More information

Farmers Savings Bank & Trust Online Banking Agreement

Farmers Savings Bank & Trust Online Banking Agreement Farmers Savings Bank & Trust Online Banking Agreement Must be 18-years or older to participate in the Online Banking General Terms This agreement (the Agreement ) made between you and us for accessing

More information

Summary Plan Description for the North Las Vegas Fire Fighters Health and Welfare Trust Health Reimbursement Arrangement Plan

Summary Plan Description for the North Las Vegas Fire Fighters Health and Welfare Trust Health Reimbursement Arrangement Plan Summary Plan Description for the Health Reimbursement Arrangement Plan General Benefit Information Eligible Expenses All expenses that are eligible under Section 213(d) of the Internal Revenue Code, such

More information

Duplicate Claims Verify claims receipt with BCBSNM prior to resubmitting to prevent denials.

Duplicate Claims Verify claims receipt with BCBSNM prior to resubmitting to prevent denials. Claims Submission Electronically : Use Payer ID 00790 For information on electronic filing of claims, contact Availity at 1-800-282-4548. Paper claims must be submitted on the Standard CMS-1500 (Physician/Professional

More information

INSIDE. Manage Complexities, Help Avoid Penalties. ibx.com/cobra. An Employer s Guide to COBRA

INSIDE. Manage Complexities, Help Avoid Penalties. ibx.com/cobra. An Employer s Guide to COBRA Manage Complexities, Help Avoid Penalties The recent ruling by the Supreme Court of the United States upholding the Health Care Reform Act does not affect an employer s obligation to offer COBRA continuation

More information

PATIENT FINANCIAL POLICIES Effective Date: June 1, 2015

PATIENT FINANCIAL POLICIES Effective Date: June 1, 2015 Cardiovascular Specialists of Central Maryland A Community Specialty Practice of Johns Hopkins Medicine 10710 Charter Drive, Suite 400 Columbia MD 21044 PATIENT FINANCIAL POLICIES Effective Date: June

More information

Preferred Risk Administrators EMPLOYER APPLICATION For Self-Funded Health Plans HOME OFFICE USE ONLY: Group Number:

Preferred Risk Administrators EMPLOYER APPLICATION For Self-Funded Health Plans HOME OFFICE USE ONLY: Group Number: Preferred Risk Administrators EMPLOYER APPLICATION For Self-Funded Health Plans HOME OFFICE USE ONLY: Group Number: Instructions for completing this agreement: 1) The employer or employer representative

More information

How To Get A Pension From The Boeing Company

How To Get A Pension From The Boeing Company Employee Benefits Retiree Medical Plan Retiree Medical Plan Boeing Medicare Supplement Plan Summary Plan Description/2006 Retired Union Employees Formerly Represented by SPEEA (Professional and Technical

More information

AUBURN BANKING COMPANY ONLINE BANKING / BILLPAY-E PLUS AGREEMENT AND DISCLOSURE

AUBURN BANKING COMPANY ONLINE BANKING / BILLPAY-E PLUS AGREEMENT AND DISCLOSURE AUBURN BANKING COMPANY ONLINE BANKING / BILLPAY-E PLUS AGREEMENT AND DISCLOSURE This Online Banking Agreement and Disclosure (Agreement) describes your rights and obligations as a user of the Online Banking

More information

Health Savings Account (HSA) A Member Guide

Health Savings Account (HSA) A Member Guide Health Savings Account (HSA) A Member Guide 1 Save the Smart Way And Maximize Your Healthcare Dollars With your BlueSolutions for HSA Direct health plan, you have the option to set up a health savings

More information

Online Banking Agreement & Disclosure

Online Banking Agreement & Disclosure Online Banking Agreement & Disclosure This Agreement provides information about the CITIZENS FIRST Online Banking service and contains the disclosures required by the Electronic Funds Transfer Act, as

More information

TIME INSURANCE COMPANY EMPLOYER APPLICATION for Assurant Self-Funded Health Plans

TIME INSURANCE COMPANY EMPLOYER APPLICATION for Assurant Self-Funded Health Plans TIME INSURANCE COMPANY EMPLOYER APPLICATION for Assurant Self-Funded Health Plans Home Office Use Only Group Number: Instructions for completing this agreement: 1) The employer or employer representative

More information

ONLINE BANKING SERVICES AGREEMENT

ONLINE BANKING SERVICES AGREEMENT ONLINE BANKING SERVICES AGREEMENT AGREEMENT AND DISCLOSURES Before using our online banking services, you must consent to receive disclosures electronically, either online or via E-mail, and read and agree

More information

Consumer ebanking for Business Set-Up Form

Consumer ebanking for Business Set-Up Form Consumer ebanking for Business Set-Up Form PRINT, SIGN and MAIL to American Savings Bank, Customer Service Center, P.O. Box 2300, Honolulu, HI 96804-2300 or DROP OFF this set-up form at your nearest American

More information

State of New Hampshire Employee Health Benefit Program. Health Reimbursement Arrangement. Benefit Booklet

State of New Hampshire Employee Health Benefit Program. Health Reimbursement Arrangement. Benefit Booklet State of New Hampshire Employee Health Benefit Program Health Reimbursement Arrangement Benefit Booklet January 2014 Table of Contents INTRODUCTION... 4 I. Benefits & Eligibility... 4 1. What Benefits

More information

FUNDING & REIMBURSEMENT

FUNDING & REIMBURSEMENT FUNDING & REIMBURSEMENT Access & manage your reimbursement funds Inside You ll learn how to use your extend health online account. which documents you should save for use. how to submit claims for reimbursement.

More information

General Terms Applicable to Bill Payment and Transfer Services

General Terms Applicable to Bill Payment and Transfer Services Please read this document carefully and print a copy for your reference. You may refer back to it at any time on this website. General Terms Applicable to Bill Payment and Transfer Services Your use of

More information

2014 Flexible Spending Account Program for Dental & Vision Care And Dependent Care Expenses

2014 Flexible Spending Account Program for Dental & Vision Care And Dependent Care Expenses To: Subject: John Deere Flexible Spending Accounts Participants 2014 Flexible Spending Account Program for Dental & Vision Care And Dependent Care Expenses Dear Participant: Welcome to Group Dynamic, Inc.

More information

Corporate Internet Banking. Authorization Worksheets

Corporate Internet Banking. Authorization Worksheets Corporate Internet Banking Authorization Worksheets CLIENT AUTHORIZATION General Company Information Company Name: Client Number: Address: City, State, Zip: Contact Name: (Maximum 35 characters) Phone

More information

Security First Bank Consumer Online Banking Information Sheet, Access Agreement and Disclosures

Security First Bank Consumer Online Banking Information Sheet, Access Agreement and Disclosures Security First Bank Consumer Online Banking Information Sheet, Access Agreement and Disclosures Welcome to Online Banking with Security First. This Online Banking Agreement and Disclosure (Agreement) discusses

More information

Online Banking Agreement

Online Banking Agreement Online Banking Agreement Liberty National Bank Online Banking Agreement ONLINE BANKING / BILL PAYING AGREEMENT 1. The Services: Use of Liberty National Bank's Online Banking Services requires at least

More information

SANGER BANK ONLINE BANKING AGREEMENT AND DISCLOSURE

SANGER BANK ONLINE BANKING AGREEMENT AND DISCLOSURE SANGER BANK ONLINE BANKING AGREEMENT AND DISCLOSURE This Online Banking Agreement and Disclosure ("Agreement") describes your rights and obligations as a user of the Online Banking service or the Bill

More information

Mobile Banking Disclosure Statement

Mobile Banking Disclosure Statement Mobile Banking Disclosure Statement This disclosure provides information about Centier Mobile Banking services. By using this service you agree to the terms and conditions stated below and any other terms

More information

OptRight Online: 2013 Year End Customer Guide

OptRight Online: 2013 Year End Customer Guide November 2013 Wells Fargo Business Payroll Services OptRight Online: 2013 Year End Customer Guide 2013 Wells Fargo Bank N.A. All rights reserved. Member FDIC. Welcome to the 2013 year-end customer guide

More information

Online Banking Agreement

Online Banking Agreement Online Banking Agreement This Online Banking Agreement and Disclosure ( Agreement ) describes your rights and obligations as a user of the Online Banking Service and Lincoln National Bank s ( LNB ) rights

More information

WELLNESS INCENTIVE (HRA) PLAN DESIGN GUIDE

WELLNESS INCENTIVE (HRA) PLAN DESIGN GUIDE WELLNESS INCENTIVE (HRA) PLAN DESIGN GUIDE Please fill out this form in its entirety and return to SelectAccount 45 days prior to your effective date in order for us to properly administer your plan. If

More information

A Reference Manual for Brokers with Prime and Complete Dental Programs

A Reference Manual for Brokers with Prime and Complete Dental Programs A Reference Manual for Brokers with Prime and Complete Dental Programs empireblue.com TABLE OF CONTENTS WELCOME TO EMPIRE BLUE CROSS AND BLUE SHIELD DENTAL PROGRAM..1 WHO TO CONTACT..2 WEB SITE 3 NEW GROUP

More information

BUSINESS ONLINE BANKING AGREEMENT

BUSINESS ONLINE BANKING AGREEMENT BUSINESS ONLINE BANKING AGREEMENT I. GENERAL DESCRIPTION OF AGREEMENT A. WHAT THIS AGREEMENT COVERS This Agreement between you and Santander Bank governs the use of our Business Online Banking service.

More information

ELECTRONIC FUND TRANSFERS YOUR RIGHTS AND RESPONSIBILITIES

ELECTRONIC FUND TRANSFERS YOUR RIGHTS AND RESPONSIBILITIES ELECTRONIC FUND TRANSFERS YOUR RIGHTS AND RESPONSIBILITIES The Electronic Fund Transfers we are capable of handling are indicated below, some of which may not apply to your account. Direct Deposits you

More information

Your Income Protection Plan Benefits

Your Income Protection Plan Benefits Your Income Protection Plan Benefits Contents Your Income Protection Plan Benefits...1 About This SPD... 1 Getting More Information... 1 Changes to the Plan... 2 Participating in the IPP...3 Eligibility...

More information

Frequently Asked Questions

Frequently Asked Questions Frequently Asked Questions Please continue to check back often as new questions and answers will be added! TABLE OF CONTENTS Benefits General. Paid Time Off (PTO). Medical. Prescription Drug Program. Flexible

More information

Health Savings Account (HSA)

Health Savings Account (HSA) Tax-Advantaged Accounts Health Savings Account (HSA) September 16, 2015 State of Tennessee, Higher Ed s University of TN and The Board of Regents Today s presentation will cover: Health Savings Account

More information

CareFirst of Maryland, Inc. CareFirst BlueChoice, Inc.

CareFirst of Maryland, Inc. CareFirst BlueChoice, Inc. CareFirst of Maryland, Inc. doing business as CareFirst BlueCross BlueShield (CareFirst) 10455 Mill Run Circle Owings Mills, Maryland 21117-5559 A private not-for-profit health service plan incorporated

More information

Flexible Benefits Program & Flexible Spending Accounts

Flexible Benefits Program & Flexible Spending Accounts Flexible Benefits Program & Flexible Spending Accounts Flexible Benefits Program & Flexible Spending Accounts The Flexible Benefits Program offers you a substantial tax savings opportunity. It allows you

More information

Benefits Participant Guide

Benefits Participant Guide Benefits Participant Guide Table of Contents Refer to the Table of Contents for a full summary of the information contained within this guide. Click the section headings to be brought directly to that

More information

Prairie State Bank & Trust ELECTRONIC FUND TRANSFERS YOUR RIGHTS AND RESPONSIBILITIES

Prairie State Bank & Trust ELECTRONIC FUND TRANSFERS YOUR RIGHTS AND RESPONSIBILITIES Prairie State Bank & Trust ELECTRONIC FUND TRANSFERS YOUR RIGHTS AND RESPONSIBILITIES The Electronic Fund Transfers Prairie State Bank & Trust (referred to as Bank, we, our, or us ) is capable of handling

More information

CDH Refresher Cindy Otley Director Marketing and Product Development

CDH Refresher Cindy Otley Director Marketing and Product Development CDH Refresher Cindy Otley Director Marketing and Product Development Cindy.Otley@CareFirst.com 410-998-7788 Visual Presentation Only CareFirst BlueCross BlueShield is an independent licensee of the Blue

More information

2015/2016 Tax Season User Guide

2015/2016 Tax Season User Guide 2015/2016 Tax Season User Guide This booklet has been designed to help you understand the process that we follow to complete your tax returns. It will help you to know when to expect information from us

More information

Bill Payment Agreement

Bill Payment Agreement Bill Payment Agreement Service Provider You authorize Altra Federal Credit Union (Altra) to utilize ipay Solutions (or another processor of our choice) to provide this service to you on the Credit Union

More information

Health savings account (HSA) administered through Kaiser Permanente

Health savings account (HSA) administered through Kaiser Permanente Health savings account (HSA) administered through Kaiser Permanente Funds from a health savings account (HSA) can be used by eligible employees to pay for any qualified expenses as defined in IRS Publication

More information

Peoples Online Services and E-Sign Agreement

Peoples Online Services and E-Sign Agreement Peoples Online Services and E-Sign Agreement This Peoples Online Services Agreement and Disclosure ("Agreement") explains the terms and conditions governing basic online services and bill pay services

More information

Benefits Participant Guide

Benefits Participant Guide Benefits Participant Guide Table of Contents Refer to the Table of Contents for a full summary of the information contained within this guide. Click the section headings to be brought directly to that

More information

BlueFund Consumer Directed Health Plan Health Reimbursement Arrangement Frequently Asked Questions

BlueFund Consumer Directed Health Plan Health Reimbursement Arrangement Frequently Asked Questions BlueFund Consumer Directed Health Plan Health Reimbursement Arrangement Frequently Asked Questions What is a Health Reimbursement Arrangement (HRA)? Briefly describe CareFirst s benefit model and services,

More information