Employee
Benefits FAQ's
FAQ's
for Health Benefits |
Q: Can I change my benefit
selection any time during the year?
A. All current health insurance enrollments or enrollment
changes you make during open enrollment will be effective
for that enrollment year. Changes to your health or
flexible benefits coverage during the 2009 year can
only be made if you have a "qualifying
change in status" during the new calendar
plan year.
Q: If I have an HMO can I
change my Primary Care Physician?
A. Yes. If you have an Aetna HMO
you can change your Primary Care Physician (PCP) to
another Physician that is on the Aetna HMO list. You
can click on the Aetna DocFind
link to find a new PCP. You can change your PCP by
calling Aetna at 1-800-807-9749 or
by logging into your Aetna
Navigator account and requesting the change to
a new physician. If you have a Kaiser Permanente
plan then you can call Kaiser at 1-800-464-4000
to request a change in your PCP.
Q: How do I get a Medical
Insurance Card?
• For Aetna HMO members call
1-800-807-9749
• For Aetna PPO members call
1-800-326-2010
• Aetna members can order new or replacement
cards by logging into their Aetna
Navigator account
• For Kaiser Permanente members
call 1-800-464-4000
Q: How do I get a Dental
Insurance Card?
A. Call Golden West Dental at 1-800-995-4124 for HMO
and PPO Dental Insurance cards.
Q. What do I do if one of
my dependents moves to an area where there is no HMO
coverage?
A. If you have an Aetna HMO please
call Aetna at 1-800-807-9749 to arrange
for your dependent to have Out-of Area coverage. If
there is no HMO coverage your dependent will be placed
in an Aetna PPO plan, however you will still pay HMO
rates if you have an HMO plan.
Q: How Do I Use the Aetna
Home Delivery Mail Order Service?
A: First you need to obtain a prescription from your
physician for a 90-supply. Physicians usually include
a number of refills. Download a copy of the Home
Delivery Mail Order form and follow the instructions
to complete the form. Then mail in to Aetna at the
address shown.
FAQ's
for Flexible Spending Accounts (FSA) |
Q. What is a Healthcare FSA?
A. Healthcare flexible spending account (FSA) allows
you to pay for qualified out-of-pocket medical expenses
on a pre-tax basis.
Q. What are qualified expenses
under a Healthcare FSA?
A. Qualified expenses must be for out-of-pocket medical
care provided to you, your spouse or dependent.. For
detailed information on allowable expenses click
here.
Q: Does the Healthcare FSA
replace my insurance plan?
A: No. This plan offers you a means to pay for eligible
out-of-pocket health care expenses with pre-tax money.
You must submit your claims to your health care, dental,
or vision plan for payment according to the plan limits
first. Then, the remaining out-of-pocket eligible
expenses can be submitted for reimbursement from your
FSA.
Q. What is a Dependent Care
FSA?
A. A dependent care flexible spending account (FSA)
allows you to pay for employment-related dependent
care services related to care of a qualifying individual
on a pre-tax basis. For a list of eligible dependent
care expenses, please click
here.
Q. Can I change my FSA election
during the calendar year?
A. Your election is irrevocable for the plan year
unless you have a qualifying
change in status as defined in the IRS Regulations.
Q: How can I check my account
balance?
A. You can log in to your account at https://www.flexdirect.adp.com/
to view your account balance. You can also call the
current FSA administrator, ADP at 1-800-654-6695 to
obtain your account balance.
Please Note: The County does
not use Social Security Numbers for ADP FSA ID numbers
but uses your employee ID as your FSA ID number. Your
ID would be SBC+00+Ee ID for example, if your employee
ID is 9999 your ADP FSA ID would be SBC-00-9999 if
you employee ID is 5 digits, i.e. 99999 then your
FSA ID would be SBC-09-9999.
Q: How do I submit a claim?
A. Please go to https://www.flexdirect.adp.com/
to obtain claim forms. Once you have completed the
forms and attached the necessary supporting documentation
or obtained the required signatures you can fax the
form to 1-866-392-4090 or 1-678-762-5900
or mail it to ADP Claims Processing, PO Box 1853,
Alpharetta, GA 30023-1853.
Q: Is there a deadline for
submitting claims?
A: You can submit claims at any time for expenses
incurred during the Plan Year. The deadlines for the
claim filing are as follows:
• March 15 – last day
to incur a qualifying FSA expense for the prior plan
year.
• June 15 – Last day to file FSA claims
for reimbursement of FSA claims incurred in the prior
plan year (between January 1 and March 15).
Q. Do have I have to re-enroll
each year in the FSA or can I “roll-over”
my selections?
A. If you choose to continue participation in the
FSA program, you must re-enroll each plan year.
Q: If I elect to contribute
money to both the Health Care and Dependent Care FSA
and I exhaust all of my health care money, can I use
my dependent care account to pay for health care expenses?
A: No. The Health Care and Dependent Care FSA are
two separate accounts. You cannot transfer money between
the two, nor submit claims that are not consistent
with the expense eligibility requirements.
Q: Can I use a Dependent
Care FSA to pay for a babysitter in my home rather
than using a day care facility?
A: Yes. You can include expenses paid to a babysitter
if the services are necessary in order for you and
your spouse, if married, to work or look for work,
or for your spouse to attend school full-time. You
may not, however, pay a relative for these services.
However when you submit your reimbursement claim you
have to submit Tax Identification Number (TIN) or
if your babysitter does not have a TIN, you must submit
his/her nine-digit Social Security Number with your
reimbursement request.
Q: What happens to the leftover
money in my FSA if I don’t spend it?
A. The "use-it-or-lose-it" rule is a provision
in the IRS Regulations. Under this provision, all
money contributed to a FSA must be used to reimburse
qualified expenses incurred during that plan year.
Money not used to reimburse eligible expenses is forfeited.
The unused portion of your healthcare FSA may not
be paid to you in cash or other benefits, including
transferring money between FSAs.
Q: What happens if I retire
or terminate employment with the County during the
plan year?
A: Under IRS regulations, you would be able to receive
reimbursement of expenses incurred prior
to your termination/retirement date. Expenses incurred
after you leave your employer are not eligible for
reimbursement. However, you may be entitled to elect
COBRA continuation coverage under the Healthcare FSA
once your coverage ends and receive reimbursement
for qualified expenses after your termination, provided
you make the required contributions to your new COBRA
Healthcare FSA.
Please Note: You will not
be able to transfer funds from your FSA that you had
while employed to your COBRA FSA as these are 2 separate
accounts.
FAQ's
for Health Savings Accounts (HSA) |
Q: What
is an HSA?
A. Think of HSAs as “medical” IRAs. They
are tax-free accounts that individuals with an HSA-compatible
high-deductible insurance plan can fund and use to
pay for medical expenses. Because they are tax-advantaged
and balances can accumulate over time; in addition,
HSAs are owned by the individual account holder and
therefore portable.
Q: Am I eligible to open
an HSA?
A. If you are enrolled Aetna HDHP (High Deductible)
PPO Plan with no other health plan coverage and not
enrolled in a health care flexible spending account,
is eligible to set up a pre-tax Health Savings Account
(HSA).
Q. What happens if I do not
use all my money in the account by the end of the
year?
A. Unlike a flexible spending account, these funds
roll over from year to year and there is no “use
or loose it provision”.
Q: What happens if I retire
or terminate employment with the County during the
plan year?
A. Unlike an FSA the money in an HSA belongs to the
account holder and is your account. You own it. You
fund it. And you can take it with you wherever you
go.
Q: How does an HSA differ
from a Healthcare FSA?
A. There are similarities, but here’s what makes
an HSA different:
