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Who do I call for questions about claims process?/ How can I get help in completing the claims reimbursement forms?
For any inquiries about this Plan, or you account, simply call BSI Administrative Services, Inc. at (212) 302-3539, or FAX 212-302-3552, or (E-mail).
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Will my claims information be kept confidential?
Yes, information provided to BSI Administrative Services, whether in writing or orally, concerning your claims will be kept strictly confidential. We do not provide claims details to any outside source (the IRS, your insurance company, your employer, etc.).
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Where can I get claims reimbursement forms?
While you can make copies of all forms, additional forms are available see GET MY FORMS.
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How do I submit a request for claims reimbursement?
The IRS rules require a written statement and proof of payment Keep original documents for your records, then submit copies directly to BSI Administrative Services,
Attn: Flex Plan, 57 West 38th St, Suite 603, New York, NY 10018.
Use the Request for Claims Reimbursement Form (Form PR3). The Claims Reimbursement Instructions (Form PR3b) provides additional details as to how to complete these claim. You can call BSI Administrative Services should you have any questions about completing your claims forms.
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How do I get reimbursed for the Healthcare Premiums account?
Eisner makes these payments for you, so you do not need to complete any claims reimbursement form. The Healthcare Premiums is the only account where payment is made directly to the insurance company. Since you don't pay first, there is no reimbursement for the amounts deducted from your paycheck. (For the Unreimbursed Healthcare and Child/Dependent Care, you pay first and have the money deducted pre-tax, so reimbursement is applicable.)
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Where do I send the claims reimbursement form? / Can I FAX the form?
The IRS rules require a written statement and proof of payment. Use the Request for Claims Reimbursement Form and follow the instructions on the back. Keep original documents for your records, then submit copies directly to BSI Administrative Services, Attn: Flex Plan, 57 West 38th Street, Suite 603, New York, NY 10018.
You can also FAX the forms and attachments to BSI Administrative Services at 212-302-3552.
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Can I E-mail the claims reimbursement form?
Not really. You will be able to E-mail the BSI Administrative Services form, but unless you include all the related attachments (proof of payment, statement of benefits if required, and detailed service descriptions), your claim is incomplete.
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How often can I submit a claims reimbursement forms?
You can submit claims as often as you like. There is no minimum dollar amount. Some folks use these accounts as savings plans and schedule reimbursement for a holiday, vacation or other specific time. If you want your reimbursement scheduled, simply attach a note as to when you want payment (also see below).
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When are the reimbursement checks processed?
For the Flex Plan (Unreimbursed Healthcare and Child/Dependent Care) accounts, properly completed claims are processed in sync with your payroll calendar; i.e., all claims received by one payroll date will be processed by the next payroll date.
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What makes a claim incomplete? What happens if my claims reimbursement form is incomplete?
A claim form is “incomplete” when it is missing your signature, does not include: proof of payment, or the statement of benefits (showing that insurance paid a portion of your expenses), or the dates of the provider services. If your claim is incomplete, BSI Admin will call you using the phone number on the claim reimbursement form to discuss what is missing and what is needed to complete your request.
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Are there any limits to the amount I can be reimbursed?
There are no minimums. Your reimbursements for any account during a Plan Year cannot exceed your annual election for that account.
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For the Child/Dependent Care reimbursement is limited to funds credited via payroll deposits into your account less amounts already paid.
For the Unreimbursed Healthcare Expenses, the amounts will be advanced up to your annual election less any reimbursements already made. (Thus, the key is amounts paid by you, not amounts deposited).
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Do I need to wait until money is in my account to submit a claims reimbursement form?
No for the Unreimbursed Healthcare account as you can be reimbursed up to your annual election at any time.
Yes for the Child/Dependent Care. You should submit a claim for whatever you pay, BSI Admin will break it down into smaller claims based on your payroll deductions credited to your account. Any moneys not paid initially, will become “claims pending” and reimbursed when the amounts are credited to your account.
For example, if you submit $5000 for Child/Dependent Care in January and are paid semi-monthly, BSI Admin will pay $208.33 for the first payroll in January and indicate that $4,791.67 is “pending.” BSI Admin will also create 23 more claims for $208.33 until you are reimbursed $5,000.
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Do I need to sign the claims reimbursement forms?
Yes, you must sign the form at the bottom to complete the Participant’s statement.
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Can I be reimbursed for Child/Dependent Care without providing the social security number (or Federal Tax ID)?
No. IRS rules require that you provide the Federal Tax ID. For an individual this is the social security number. In many cases this is the payroll tax ID.
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Can I submit copies? Do I have to submit originals?
Yes, only submit copies to BSI Administrative Services. Do not submit originals --- keep all original documents for your records.
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What is Proof of Payment?
To receive reimbursement you pay first, then provide proof of payment from a third party provider. If such proof is not available, then you must note “proof will be provided to the IRS if requested.”
For example, as proof of payment submit either: a bill marked paid, or a copy of both sides of your canceled check, or credit card receipt, or an account statement showing payments, , or for over-the-counter drugs a copy of the cash register receipt (if specifically labeled, otherwise copy the cash register receipt and the product label), or a prescription drug label.
You can also use the Proof of Payment (Form P) when your provider does not give you a bill or provide a statement. While originally designed for child care, you can also use it for healthcare (simply darken the bottom heading).
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Why do I need to submit a cancelled check?
These accounts are reimbursement accounts. You pay first, then are reimbursed. (You would be paying these bills anyway even if you were not in this plan.) Reimbursement is made payable to you. We cannot pay the bills for you. The IRS rules indicate a cancelled check, both sides are required. However, we accept bank images, or the front side with a note that the cancelled check will be provided to the IRS if requested.
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Do I have to submit a claim to insurance first? Insurance claims take too long, can’t I just submit a claims reimbursement form first?
Yes, you use your insurance coverage the same whether or not you are using a Unreimbursed Healthcare account. This will insure that you deductible is credited if you go out-of-network, as well as provide a Statement of Benefits showing what amounts insurance allows and is willing to pay for you. It is not required if the expense involves a copay or there is no insurance coverage.
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Why do I need to submit the insurance “Statement of Benefits”?
We work with all insurance companies. So when insurance pays a portion of your expenses you must attach a copy the Statement of Benefits. This Statement of Benefits shows your liability, it does not show that you actually paid for the services.
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Isn’t the Statement of Benefits proof of payment?
No, while the insurance company statement will show amounts claimed, amounts the insurance company will pay and amounts you will have to pay, it doesn't show that you did actually pay for the balance not reimbursed by insurance. Remember, you must pay first, then you can get reimbursed.
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Do I have to list each health service on the claims reimbursement form?
No, if the backup details the specific service dates, you can indicate “see attached” or simply give a range of dates (to/from); for example, 9/2 – 12/2/04, or Jan – June.
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Can I use the expenses reimbursed in the Flex Plan as itemized on my tax return as deductions or credits?
No, once you have used expenses in the Flex Plan you may not apply them toward either the itemized deductions or child/dependent care credit.
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What if the Transportation Expense Form (PR4) and why is it optional?
The Transportation Expense Form (Form PR4) is an optional form to be used with the Unreimbursed Healthcare or Child/Dependent Care accounts. It is used for transportation for healthcare for child/dependent day care services.
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What do I do if I lose or don’t get a reimbursement check?
If you don’t get your check on your payroll date or lose the check simply call or contact BSI Administrative Services.
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Can I have my reimbursement check directly deposited to my bank account?
You must first complete the Direct Deposit Authorization (Form DDA) which will allow us to setup this services.
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Can I be reimbursed for Child/Dependent Care without providing the social security number (or Federal Tax ID)?
No. IRS rules require that you provide the Federal Tax ID - - for an individual this is the social security number.
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What about the tax credit for child and dependent care?
Expenses reimbursed from the child/dependent care account cannot also be claimed as a tax credit on your individual tax return (Form 1040, line 41). Please consult your tax advisor as to whether to choose the tax credit or the deduction.
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Can the payments be sent directly to the provider of the service?
Except for the Healthcare Premiums account which is paid directly by your employer who combines your contributions with company contributions, all reimbursements must be made payable to you (or your beneficiary if you die).
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Can advance payments for healthcare or dependent day care be reimbursed?
No, you pay first, then are reimbursed as checks made payable to you are mailed to your home.
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BSI Administrative Services. All Right Reserved.
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