Claims Workshop

BenefitHelp Solutions (BHS) is our claims processing company for benefits for our Flexible Spending Account (FSA) and our Health Reimbursement Account (HRA).

If you signed up for the Benefits Card it is an MDI MasterCard, so look at the card when you get it, it can be used just like a credit card. If you haven’t received the card in the mail, or if you think you have lost it contact Tina Roy at 440-4406, or call BenefitHelp Solutions at 888-784-7954.

The FSA account is a ‘use it or lose it’ account, the HRA account is a ‘don’t use it keep it’ account.  When you submit a claim the transaction amount is automatically deducted from the appropriate spending account.  If you have an FSA account it will use funds from that account before using the funds in your HRA account.

The Benefits Card, when used at the point of service, means no out of pocket expenses.  There is no waiting for reimbursement because the funds are automatically deducted from your account through BHS.  You can use the Benefits Card at pharmacies, hospitals, eye clinics and dentist offices.  When you use your Benefits Card at a self-service merchant terminal, be sure to select the ‘credit’ option.  DO NOT select ‘debit’ as there is no PIN number to enter.  Your card will not work at ATM locations.

If you have an FSA account, save your receipts throughout the year for anything you would purchase in a pharmacy, ie bandaids, over the counter medicines, cough drops etc.  If, at the end of the year, you haven’t used up the funds in your FSA account, you can fill out an FSA reimbursement form, available online, to use up the rest of the money you have in that account. 

Supporting Documentation
When you receive supporting documentation requests you may fax or mail the letter requesting the information along with the supporting documentation, which will include:

Overcharges
If your doctor overcharges your Benefits Card, ask the doctor’s office to refund your HRA account with your Benefits Card.  Otherwise you would have to send a check for the overcharged amount to BHS to put back into the account it was taken out of.  The doctor’s office would send you a check to reimburse you the overcharged amount.

Eligible Healthcare Expenses
If you use the Benefits Card to pay for eligible healthcare expenses, you are limited to your maximum annual election.  If you use the Benefits Card to pay for eligible dependent care or commuter expenses, the provider of service cannot swipe more than your current account balance or the transaction will be denied.  You need to inform your provider the maximum amount they can swipe from your Benefits Card.
Douglas County fronted the entire amount for 2007 in January, so if you have the Single HRA you have $900 in your account or $1800 if you chose the Family HRA.  If you terminate before the year is up, and you have money in the account, you will only be able to keep the amount for the time you actually worked.   BHS will reimburse the County for the remainder of the year.  For example, if you terminated in July and you haven’t used anything in your account, the single account will have a balance of $450, the family account will have $900.  This account is yours to use until the funds have been used.  If you have used more than the 6 month dollar amount, BHS will count their losses and you won’t owe anything more.   This may be the only year the County will put all the money in the account at the beginning of the year, they did this year because it is a new account and wanted their employees to access their insurance benefits immediately. 

Rules

Services available online at www.benefithelpsolutions.com           

Lost or Stolen Benefits Cards
If you lose your card, or your card has been stolen, notify BenefitHelp Solutions immediately at 888-784-7954. If a fraudulent purchase is made against your spending account, a claim must be made with MasterCard. MasterCard will credit your Benefits Card after they have completed their investigation process.