Human Resources

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 2016 year can only be made if you have a "qualifying change in status" during the new calendar plan year.

 

Q: How do I get a Medical Insurance Card?

  • For Blue Shield members call 1-800-642-6155.
  • Blue Shield members can order new or replacement cards by logging into their Blue Shield Member  account. If you have not created an account the website will guide you to create an account.
  • For Kaiser Permanente members call 1-800-464-4000.

Q: How do I get a Pharmacy Benefit Card?

  • For Blue Shield EPO and PPO plan members please call Express Scripts at 1-800-711-0917. Do not call Blue Shield's member services as your pharmacy benefits are managed by Express Scripts.
  • Blue Shield EPO and PPO plan members can also order or print a Pharmacy Benefit card by logging into their member account at https://www.express-scripts.com/. If you have not yet created an account the website will guide you to create an account.
  • Blue Shield HDHP plan members need to call Blue Shield's member services at 1-800-642-6155 for questions regarding their pharmacy benefits as their pharmacy benefits are managed by Blue Shield.

Q: How do I get a Dental Insurance Card?

  1. Call Delta Dental at 1-800-422-4234 for PPO Self-funded Dental Insurance cards and 1-800-765-6003 for DeltaCare USA Dental Insurance cards
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 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 by HIPAA Special Enrollment rules and IRS Section 125 Regulations.

 

Q: How do I submit a claim?

A. The forms are available here. Once you have completed the forms and attached the necessary supporting documentation or obtained the required signatures you can fax the form to 412-276-7185, scan and email the forms to fsa-claims@benxcel.com or mail it to BCC Claims Processing, 2 Robinson Plaza, Suite 200, Pittsburgh, PA 15205

 

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 Blue Shield 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:

  • Your HSA rolls over each year – there is no “use it or lose it” rule – so you can accumulate funds for future health expenses.
  • Your HSA is portable – it’s your own account, so you use the same account from one employer to the next.
  • Interest or investment earnings on the HSA funds are tax-free.

Q: Can I have FSA and a HSA?

A. You may have a Dependent Care FSA and a HSA but according to IRS regulations you cannot have Healthcare FSA and an HSA.