THE NUESYNERGY DIFFERENCE - Microsoft...THE NUESYNERGY DIFFERENCE HEALTH REIMBURSEMENT ACCOUNT (HRA)...

THE NUESYNERGY DIFFERENCE

HEALTH REIMBURSEMENT ACCOUNT(HRA)

WELCOME KIT

4601 College Blvd. Suite 280 • Leawood, KS 66211 • 855.750.9440 • www.MyKansasCDH.com

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http://www.kansasfsa.com


TABLE OF CONTENTSYour Health Reimbursement Account (HRA) 3

Online Registration 4

Online Direct Deposit 5

HRA Debit Card 6-8

NueSynergy Mobile App 9

How to File a Claim 10-11

Eligible Expenses 12

Direct Deposit Authorization Form 13

Debit Card Enrollment 14

HRA Claims Reimbursement Form 15

Common FAQs 16-18

Contact Us 194601 College Blvd. Suite 280 • Leawood, KS 66211 • 855.750.9440 • www.MyKansasCDH.com



YOUR HRAThe Health Reimbursement Account, also known as the HRA, is an employer sponsored ac-count that is funded entirely by your employer. The HRA can be used to reimburse a portion of your out-of-pocket medical expenses for you and your eligible family members. Claims processing works similar to the Healthcare FSA in that you must provide documentation to substantiate your claims. Also if you enroll in the HRA and would like to make pretax contribu-tions, you may also enroll in the Healthcare FSA.

Who is eligible for the HRA?

Members who enroll in a High Deductible Health Plan are eligible to enroll in the HRA. Some members are only eligible for an HRA because of one the following factors apply to your situ-ation. - You are enrolled in any part of Medicare - You are enrolled in Tricare -YouarecoveredbyanotherplanthatisnotconsideredaQualifiedHighDeductible Health Plan - You are claimed as a dependent under your parent’s taxes

If you enroll in Plans J or Q, you will need to enroll in the HRA in order to have access to any HealthQuest dollars you have earned.

HRA Funding

Employer contributions made by the State Employee Health Plan will be made in the same frequencyastheHSA,whichwillbequarterlyonthefirstpaycheckofJanuary,April,July,and October. Non-State employer groups will receive their contributions monthly.


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ONLINE REGISTRATION

TO BEGIN STEP 2 STEP 3 STEP 1

• Go to www.MyKansasCDH.com • Click Log in > Member Registration

• Read all instructions • Start by creating a username•Filloutremainingrequiredfields

including your Employer ID: NUESOK • For Employee ID use your State of Kansas ID • Accept terms of use • Click next

•Confirmyouremail address• Click next

•Confirmyour information • Click submit

TO BEGIN STEP ONE

STEP THREE

STEP TWO

STEP THREE

• Fill out security questions • Click next

STEP FOUR

Accessing your account through the online member portal will enable you to submit claims electronically for faster approval, as well as access balance and claims history, important communications and more.

Setting up your account for online access is easy! Just follow the steps below. (For additional help you can download the Registration Guide with step by step screen shots at www.MyKansasCDH.com.) Important: To complete your online registration, you will need your Employer ID: NUESOK and for Employee ID, use your State of Kansas Employee ID.

• You’ve successfully completed the registration process

YOU’RE FINISHED!


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ONLINE DIRECT DEPOSIT

STEP 3

•After registering, sign in to your account and select “Get Reimbursed Faster” on the homepage

STEP ONE

STEP TWO

STEP THREE

STEP TWO•Reviewtheexampleonthescreenofwheretofind your routing and account number on your check •Input both numbers exactly as they appear on your check. •Click save

YOU’RE FINISHED! •You’ve successfully completed the online direct deposit process

STEP TWO


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HRA DEBIT CARD


The free NueSynergy HRA debit card provides a convenient method to pay for out-of-pocket medical expenses for you, your spouse and/or any tax dependents. The IRS imposes strict regulations on where the HRA debit card canbeusedandwhenfollow-updocumentationisrequiredtosubstantiateaqualifiedexpense.Thecardisaconvenientbenefit,butitisimportantthatyoutakeamomentandunderstandhowitworks.Asaparticipantinthe HRA you will automatically receive a debit card. Should you wish for your eligible spouse or dependent to also have a debit card, please complete and return the Debit Card Enrollment form on page 14 at your earliest convenience.

Where is the NueSynergy HRA debit card accepted?ParticipantscanusetheHRAdebitcardatqualifiedmerchantstopayforqualifieditemssuchas: •Officevisits • Deductible-related expenses • Prescriptions • Dental work (including orthodontia) • Eyeglasses & contacts

How does NueSynergy verify that the HRA debit card is used only for qualified expenses?TheIRShaslimitationstohelpensurethatthecardisusedonlyforqualifiedexpenses.Whenthecardisswipedataqualifiedmerchantandthereisasufficientbalanceavailableintheparticipant’sHRA,thequalifiedpur-chase will be paid directly from the reimbursement account.

The IRS requires participants to keep all receipts for HRA expenses for seven years in the event of a tax audit. If there is a discrepancy or unusual transaction amount, NueSynergy is required by the IRS to verify the transaction. If a transaction cannot be electronically substantiated a participant will be sent a notification via email to submit a third-party receipt showing the date of service, description or type of treatment and the amount owed.

All plan communication pertaining to your account activity is provided solely via email and at www.MyKansasCDH.com. It is important to notify NueSynergy if you change your email address.

What are the advantages of using the NueSynergy HRA debit card?Participantswhousethecardatqualifiedmerchantsmaypayforeligibleexpenseswithouthavingtosubmitaclaim and wait for reimbursement. Participants can logon to www.MyKansasCDH.com for real-time, online ac-count information including balance, deposits made to date and a list of pending and completed payments.

Recurring HRA debit card expenses for the exact amount at the same provider can be set up as a recurring transaction. When you submit your initial documentation, please include a note stating the transaction will be a recurring expense. This will prevent the need for additional documentation on future purchases of the same item purchased at the same provider.

Does the participant always have to use the HRA debit card for claim reimbursement?No. There will be times when a merchant does not accept the HRA debit card. This does not mean that the expense is not eligible. Participants will need to pay for the expense from their personal funds and then submit a claim for reimbursement. Claim forms can be found at www.MyKansasCDH.com.

How do I send my required documentation for substantiation of my HRA debit card transactions?You can submit documentation by using NueSynergy Mobile, your member portal at www.MyKansasCDH.com, or by faxing, emailing or mailing completed forms and copies of bills, receipts, or invoices to:

NueSynergy4601 College Blvd, Suite 280, Leawood, KS 66211Fax: 855.890.7238Email: [email protected]

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mailto:customerservice%40NueSynergy.com?subject=


HRA DEBIT CARD cont’d


How to Substantiate Your Debit Card Transaction

The NueSynergy HRA debit card provides a convenient method to pay for out-of-pocket medical expenses for you, your spouse, and/or any tax dependents. The IRS requires documentation to be provided at certain times to ensure the card is being used to pay for eligibleexpenses.TheHRAdebitcardisagreatbenefit,butyou’llwanttobesureyouknowhow to substantiate your debit card transactions if need be.

Onceyoureceiveanotificationthatyouhaveapendeddebitcardclaimyoucanfax,email, or attach your receipt online at www.MyKansasCDH.com.

STEP ONE • Log in to your online account at www.MyKansasCDH.com and select Claims > Claims Activity from the Navigation menu

STEP TWO • You will be directed to Claims Activity • Click “Add Receipt” under “Action Needed” to attach your electronic claims documentation

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http://www.KansasFSA.com



HRA DEBIT CARD cont’d


STEP THREE • Drag and drop, or click “Browse” to select your electronic documentation and then click “Submit” to attach that documentation to your debit card transaction

STEP FOUR • Your receipt has now been attachedto your debit card transaction and is pending approval from NueSynergy

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NUESYNERGY MOBILE APPNueSynergy is excited to offer you a new way to access your account! By downloading the NueSynergy Mobile app on either your Apple or Android mobile device, you will have a singleaccesspointtomanageyourbenefitaccount.

TO BEGIN STEP 3 STEP 1

STEP ONE

STEP THREE

STEP ONE • Access App Store (iPhone) or GooglePlay (Android) • Search for NueSynergy • Select install and accept app permissions • Select the app once NueSynergy Mobile is downloaded

NueSynergy Mobile enables you to: • See detailed account information• View your account balance and plan details• Review recent transactions and details• View all email and SMS alerts• Contact administrator from mobile application via email or mobile phone• Submit a claim for substantiation• Take a photo of a receipt or bill and attach it to a new or existing claim or debit card transaction for approval

STEP TWO • Sign in using the same username and password as for your Participant Portal at www.MyKansasCDH.com (If you have not yet registered your account onlineyou can do so on the mobile app as well byselecting the “Register” button at the bottom of thesign on screen)

You can download the NueSynergy Mobile Application by going to either the App Store on your Apple device or GooglePlay on your Android and searching for NueSynergy:


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HOW TO FILE A CLAIM

TO BEGIN STEP 2 STEP 3 STEP 1 • Go to www.MyKansasCDH.com • Log-in to your online account • Click “Claims” • Select “Submit Claim for Reimbursement”

STEP ONE

STEP TWO

STEP THREE

STEP TWO • Enter your claim detail • Drag and drop, or upload your scanned receipts•Readcertificationstatement • Click box to agree • Click “Submit”

FILE YOUR CLAIM ONLINE

One of the easiest ways to submit your claim for reimbursement is by completing our online claim form at www.MyKansasCDH.com.Onceyourclaimisprocessedanemailnotificationwillbesenttoyouremailaddressonfileconfirmingapprovalorrequestingadditionaldocumentation.


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HOW TO FILE A CLAIM (cont’d)FILE YOUR CLAIM WITH NUESYNERGY MOBILE

Filing a claim with the free NueSynergy mobile app is fast and easy. Once your claim is processed,anemailnotificationwillbesenttoyouremailaddressonfileconfirmingapprovalor requesting additional documentation.

TO BEGIN STEP 3 STEP 1 • Log-in to the NueSynergy Mobile App • Click “Claims” • Click + on the screen’s top right corner to add anexpense or submit a claim

STEP ONE

STEP THREE

STEP TWO• Fill out all required information to submit a claim• Click “Preview”• Review your information and click “Submit”

FILE A PAPER CLAIM

You can download a copy by going to www.MyKansasCDH.com.

Claims can be faxed or emailed to NueSynergy at: Fax: 855.890.7238 | Email: [email protected]


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ELIGIBILE EXPENSES


Health Care Expenses

The IRS allows certain medical, dental, vision, and related services to be reimbursed through an HRA. Below is a partial list of expenses that qualify for HRA reimbursement. Over the Counter medications prescribed by a physician, while not listed below, are still eligible for HRA reimbursement. This list is subject to change and without notice due to new legislation. For a complete list, log on to www.MyKansasCDH.com.

Medical Expenses Medical ExpensesAmbulance service Drugs (prescriptions)Bandages, Band-Aids, wraps, and splints Eyeglasses, prescription (includes prescription

sunglasses and over-the-counter reading glasses)Chiropractor professional fees Hospital servicesContact Lenses/solution OrthodontiaDentaltreatment(includesexams,x-rays,fillings,root canals, gum disease treatment, crowns, bridges, dentures, implants, and orthodontia; does not include cosmetic treatments such as teeth whitening, bonding, etc.)

Orthopedic devices

Diagnostic services and tests Physical therapy

*For a more comprehensive list go to the site mentioned above.

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AUTHORIZATION FORM


Direct Deposit Authorization Form

Direct deposit of your HRA reimbursements is a convenient feature. By completing the authorization formbelow,youaredirectingyouremployerandfinancialinstitutiontodeposityourreimbursementsto the checking or savings account you designate.

To sign up for direct deposit, simply complete the form as directed below and return it to NueSynergy, your HRA administrator. Be sure to: • Fill out the form completely. • Mark the appropriate box to indicate whether your reimbursement will be deposited to your checking or savings account. • Attach a voided check to the form if you want reimbursements deposited in your checking account. Attach a voided deposit slip if you want reimbursements deposited to your savings account. Banking Information: Checking (attach a voided check) Savings (attach a deposit slip) Employer: _________________________________________________________________________________________________Employee/Participant Name: _______________________________________________________________________________Social Security Number or Employee ID: _____________________ Date of Birth: __________________________________Address: ___________________________________________________ City/State/Zip: ________________________________Daytime Phone: ____________________________________________ Email: ________________________________________Financial Instutution/Depository: ____________________________________________________________________________Branch: ____________________________________________________________________________________________________City: _______________________________________________________ State: _________________________________________Account #: _________________________________________________ Routing # (9 Digits): ___________________________*Direct deposit cannot be processed without a voided check/deposit slip

By completing and signing this Authorization Form, I, the PARTICIPANT, am directing my EMPLOYER/ADMINISTRATOR and FINANCIAL INSTITUTION/ DEPOSITORY to deposit my reimbursements to my designated checking or savings account. The FINANCIAL INSTITUTION/ DEPOSITORY indicated above is authorized to credit the same to such account. I also authorize my EMPLOYER/ADMINISTRATOR to draw drafts on my account or to initiate debit entries to my account, solely for the purposes of adjusting an error resulting from a deposit or credit entry that has been made under this Authorization in an amount that is not correct. The FINANCIAL INSTITUTION/DEPOSITORY shall not be liable for honoring any draft, debit entry or withdrawal initiated by my EMPLOYER/ADMINISTRATOR.

Should my EMPLOYER/ADMINISTRATOR be unable to stop from posting an entry with respect to which I, the PARTICIPANT, has requested cancellation or amendment or should the EMPLOYER/ADMINISTRATOR be unable to withdraw the entry from the ACH Origination System, I, the PARTICIPANT, may initiate a reversal to correct the entry, as provided by the ACH Rules. Where I, the PARTICIPANT, initiate a reversal for an individual entry, I, the PARTICIPANT, must notify the EMPLOYER/ADMINIS-TRATOR of the entry no later than the settlement date of the reversing entry. Reversals do not guarantee that the funds will be returned and the EMPLOYER/ADMINISTRATOR shall not have liability if such reversal is not effected. I, the PARTICIPANT, shall reimburse my EMPLOYER/ADMINISTRATOR for any expense, losses, or damages the EMPLOYER/ADMINISTRATOR may incur in effecting or attempting to affect the reversal of an entry.

Signature: ______________________________________________ Date: _______________________ 13

State of Kansas Employee Health Plan



DEBIT CARD ENROLLMENT


NueSynergy HRA Debit Card Enrollment Agreement

As a participant in the State Employee Health Plan’s HRA Plan, you will receive a NueSynergy HRA Debit Card, and agree to use it according to this Agreement and the Cardholder Agreement that will be provided to you with the Card. Your NueSynergy Mastercard HRA Debit Card will be valid for three consecutive plan years.

You understand that the Card is restricted to certain merchant categories and is not accepted at all MasterCard® acceptance locations. You understand that you may not obtain a cash advance with the Card at any merchant, bank or ATM. You understand that the Card is to be used exclusively for QualifiedExpensesasdefinedbytheplan(s)inwhichyouparticipate.IftheCardisissuedpursuanttoEmployerPlansandyouusetheCardforanexpensethatisnotaQualifiedExpense,youareindebtedtoyouremployerandmustrepaythefullamountofthenon-qualifiedexpense.

You agree to save all invoices and receipts related to any expense paid with the HRA Debit Card; upon request you must submit these documents for review by the Plan Service Provider. Failure to submitthereceipt(s)willcausetheexpensetobetreatedasanon-qualifiedexpenseandyouwillberequired to remit payment to NueSynergy in order to repay your plan. Payment may be in the form of an offsetting claim, a personal check, online personal checking account information which will create an EFT, or other options established by your employer.

ForproperCardholderIdentification,pleasecompletethefollowinginformation.It’simportanttoprovide an email address so that you can receive notices of your account activity and requests for claims substantiation. Without an email address we cannot provide you with account notices. Your Card cannot be issued until this form is received by your Plan Service Provider.

Employer: _________________________________________________________________________________________________Name on Card: ____________________________________________________________________________________________*20 characters maximum, including spaces

Address: ____________________________________________ City/State/Zip: ________________________________________Social Security Number: _____________________________ Date of Birth: _________________________________________Home Phone: _______________________________________ Email: ________________________________________________Name on 2nd Card: ________________________________________________________________________________________*20 characters maximum, including spaces

ALL FIELDS REQUIRED

Signature: _______________________________________________ Date: _______________________ 14




REIMBURSEMENT FORM


Health Reimbursement Account (HRA) Claims Reimbursement FormEmployer: ________________________________________________ Social Security Number: ________________________Employee Name: _________________________________________ Date of Birth: __________________________________Home Address: ___________________________________________ City/State/Zip: _________________________________Email*: ___________________________________________________ Work Phone: __________________________________Change of Address: _______________________________________________________________________________________

Unreimbursed Medical Expenses (copies of cancelled checks, credit card slips or balance due statements are not allowed.)

Apply Claim to Plan Year Service Date Expense Description Person for Whom Expense Incurred Amount Prior Current Prior Current Prior Current Prior Current Prior Current Prior Current

*All plan communication pertaining to your account activity is provided solely via email and the www.MyKansasCDH.com website. It is important to notify NueSynergy if you change your email address.

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TheundersignedparticipantinthePlancertifiesthatallexpensesforwhichreimbursementorpaymentisclaimedbysubmission of this form were incurred during a period while the undersigned was covered under the Employee’s Flexible Spending Arrangement with respect to such expenses and that the medical expenses have not been reimbursed or are not reimbursable under any other health plan coverage. The undersigned fully understands that he or she alone is fully responsibleforthesufficiency,accuracy,andveracityofallinformationrelatingtothisclaimwhichisprovidedbytheundersigned, and that unless an expense for which payment or reimbursement is claimed is a proper expense under the Plan, the undersigned may be liable for payment of all related taxes on amounts paid from the Plan which relate to such expense.

Signature: _______________________________________________ Date: _______________________

Visit www.MyKansasCDH.com or call us at 855.750.9440 to check on the status of your claim. Fax, email or mail completed forms and copies of bills, receipts or invoices to:

NueSynergy, Inc.4601 College Blvd, Suite 280Leawood, KS 66211Toll-Free: 855.750.9440 • Fax: 855.890.7238 Email: [email protected]

For Office Use Only: Amount Approved: Amount Rejected: Rejected by:







COMMON FAQs


Below is a list of answers to commonly asked questions. A complete list of FAQ’s can be found by going to www.MyKansasCDH.com.

Q: What is an HRA?A: Health Reimbursement Account (HRA) is an employer sponsored account that only the employer can contribute to. The State Employee Health makes contributions to the HRA on a quarterly basis. If you are a non-state employee, you will receive a monthly HRA contribution.

TheHRAcanbeusedtohelpyoupayforqualifiedmedical,dentalorvisionexpenses.Theseexpenses include dental visits, prescription drugs, eyeglasses, contact lenses and chiropractor. Please see page 12 of this welcome kit for a more complete list.

HRA contribution amounts are listed below:

Plan C Contributions: Employee Only Coverage- $1000 per year, $250 per quarter Employee+Spouse Coverage- $1250 per year, $312.50 per quarter Employee+Children Coverage- $1750 per year- $437.50 per quarter Employee+Family Coverage- $1250 per year, $312.50 per quarter

Plan N Contributions: Employee Only Coverage- $500 per year, $125 per quarter Employee+Spouse Coverage- $625 per year, $156.25 per quarter Employee+Children Coverage- $875 per year- $218.75 per quarter Employee+Family Coverage- $625 per year, $218.75 per quarter

Wellness dollars can be earned for HRA accounts.

Q: Who owns the HRA?A: Your employer owns the arrangement and determines the scope of how it is set up and used, including the amount you and each employee will receive. The HRA is not portable; if you change employers, the arrangement and any funds stay with the employer.

Q: Who can contribute to an HRA?A: Your employer owns the arrangement and determines the amount employees will receive.

Q: How do participants benefit from an HRA plan?A: TheHRAplanbenefitsparticipantsbyallowingthemtobereimburseduptoaspecifiedamounteach year for certain eligible health care expenses. Each dollar that goes into the plan is provided by theemployerforthepurposeofhealthcareexpenses,sothebenefitisfreefromfederal,stateandSocial Security taxes.

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COMMON FAQs (cont’d)


Q: Who is eligible to elect to the HRA?A: Any employee enrolled in Plan C or N may elect to have an HRA. Employees who are not eligible to contribute to a Health Savings Account (HSA) because of one of the following reasons will need to elect the HRA option:

• Medicare enrollment • TRICARE enrollment • Concurrent enrollment in another health plan not considered a High Deductible Health Plan • You are eligible to be claimed as a dependent under your parent’s tax return • You have dependent children between ages 23-26 (member may choose to enroll in either the HSA or an HRA in this situation)

Employees selecting Plans J or Q will also have an HRA for any HealthQuest Reward dollars they earn through completing eligible HealthQuest activities.

Q: What are the tax advantages and benefits of an HRA?A: Reimbursements made from your employer through the HRA are not considered part of your income and are not taxed. Contributions made to your HRA are 100 percent employer-funded, free of federal, state and FICA taxes. The distributions for medical expenses are also tax free. An HRA plan may save you money through lower premiums and tax-free medical reimbursements.

Q: What types of eligible expenses can I use my HRA for? A: The HRA can reimburse for eligible medical expenses just like with the HSA and FSA. Some examples of medical expenses that you can spend your HRA funds for include: • Deductibles and Coinsurance • Dental, Drug and Vision expenses • Over the Counter medications, such as aspirin, cold medicines, antacids and cough supple ments if you have a prescription from your doctor

Q: What happens to my HRA if I terminate employment?A: The HRA is not portable and should you terminate coverage with the SEHP prior to the end of the planyear,youwillhavesixty(60)daysfromyourlastdateonSEHPcoveragetofileanyclaimsincurred while you were covered that plan year.

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COMMON FAQs (cont’d)


Q: Do I still need to keep my receipts and documentation for prescriptions and office visits, plus the Explanation of Benefits that are sent to me?A: Yes. You should keep your original receipts and documentation for prescriptions and health-relat-ed expenses for all transactions (including payment card transactions), so you’ll have them if needed to verify a claim. The IRS requires that all transactions be validated, including the payment card transactions. If we need additional documentation, we’ll contact you and you’ll be asked to provide documentation with receipts. Failure to respond promptly to a request can result in the expense be-ing labeled as “ineligible,” in which case, you would be obligated to reimburse your account through NueSynergy. In addition, your payment card could become deactivated.

Q: Do I have to submit receipts with my HRA claims even if I use the debit card?A: Yes, The IRS requires that all transactions be validated, including any debit card transactions. Throughout the year, you should submit copies of your receipts and documentation for prescriptions and health-related expenses (including debit card transactions), in order to receive reimbursement from your account or to verify a claim made with your debit card.

Q: How long will I have to submit claims for reimbursement after the plan year ends?A:Participantswillhavesixty(60)daysfromtheendofaplanyear(December31st)tofileanyclaimsincurred during that plan year.

Q: Are over-the-counter items eligible for reimbursement under my HRA?A: Over-the-counter medicines and drugs require a prescription from your doctor in order to be reim-bursed through an HRA.

Q: What web browsers can I use to access my account online?A: www.MyKansasCDH.com requires the most recent versions of Internet Explorer, Firefox, and Chrome. Further Questions?NueSynergy is the administrator for your plan. We can be reached at 855.750.9440 | Monday-Friday from 7:30AM – 5:00PM, CST.

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NUESYNERGY CONTACT US


Have questions about your account? NueSynergy is here to help! Our knowledgeable team will make sure you get the support you need. We look forward to hearing from you.

855.750.9440 [email protected], Inc.4601 College Boulevard, Suite 280Leawood, KS 66211

NueSynergy ABOUT US

Since 1996, NueSynergy has provided clients with full-service administration of consumer-driven and traditional account-based plans. Located in Leawood, Kansas, we have built a reputation throughout the US with both Fortune 1000 corporations and small businesses for our technology-based solutions and knowledgeable, personalized service. All operational divisions from executive management to customer service are housed at our corporate headquarters. This operational design translates into improved communication andoperationalefficiencies,ensuringclientsreceivefaster,seamlessservice.NueSynergyoffers a fully integrated suite of administration services, managed by subject matter experts with an average of 10 years direct industry experience.

Our administration services include:

■FlexibleSpendingArrangements■HealthSavingsAccounts■HealthReimbursementArrangements

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http://www.nuesynergy.com

mailto:customerservice%40nuesynergy.com?subject=


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