Join the Meeting Place for Moms!
Talk to other moms, share advice, and have fun!

(minimum 6 characters)

Working Moms Working Moms

Ask A....Flex Plans Claims Supervisor

Posted by   + Show Post

This weeks ask an expert is....IBNeaters. She is a claims supervisor for a company that manages flex plans. She is here to answer any questions you may have about the specific job and any flex plan related questions.

doctor

If you missed the sign up and want to be a part of Ask an Expert, the sign up post is here: http://www.cafemom.com/group/47645/forums/read/16942641/Ask_an_Expert_Sign_Up

by on Aug. 6, 2012 at 2:20 PM
Replies (11-20):
IBNeaters
by Member on Aug. 6, 2012 at 3:50 PM

Yes, normally we get an updated list every January where bigger things have changed such as mileage rates and caps on how much you can withhold, but every quarter, the IRS sends out updates to our manuals as well.  If there is ever any question, my immediate supervisor will go to these manuals (which are quite large) to make sure, but there is training at least once a year for basic processor how-to's and we all have access to 'the list' (what is eligible and what is not) online.  And, as we go along, if there is ever any question as to the validity of a claim, there is usually someone on chat who can answer questions.  If one of us is not available, than the claim is 'escalated' to me or my supervisor so we can take a better look at it.  Once processed, an image of the claim and an explanation of how we handled is sent out to the processing team for future issues.  Of course, there are always hiccups, but we try to be as informed as we can be to make sure we expedite claims in a timely manner (hopefully within 24 hours of receiving the claim).  Most of the training takes place online, but as I am one of the ppl who are supposed to have the most knowledge, I usually train in-house.  The last training session we had was a week-long because we had several changes in our department as well as new regulations.  

Quoting deccaf:

Is there special training you attend to keep up with all the law changes? 



M4LG5
by Valeri on Aug. 6, 2012 at 4:25 PM

I really love the dependent care flex plan and am trying to get a friend on it but she shares custody of their daughter.  How can that work for both of them to use the dependent care plan with their company?

IBNeaters
by Member on Aug. 6, 2012 at 6:36 PM

Whoever 'owns' the plan is the one who can use it.  If she gets on the dependant care plan and her bd does not, then only she would have access to it.  Then, she would just have to get either a signed receipt from her daycare provider for her portion or get an itemized statement from a preschool.  If both of them have a plan, then they would need to get separate receipts and agree on how to itemize it.  It does work and we have many participants who do this, but it just takes communication.  Dependant care is one of the easiest receipts to get in most cases as well.  We actually have a form you can fill out which includes dates of service, amount paid and a spot for a provider's signature--that can be daycare, preschool, kindergarten enrichment or before/after school care.  In most cases, as long as there's a signature from the provider, we don't really question anything else.  I do have to say, though, that dependant care receips usually need to be itemized at least by month.  So let's say they each pay 250 per month and they each have a plan.  They can each submit a receipt for 500 for the month of January, but only claim 250 on the claim form and that would be accepted.  Or they could each get a receipt for 250 from the care provider and submit that--we really don't ask too many questions in dependant care cases--as long as there's a provider's signature.  If she's the only one who has an account and he just pays cash, the same would apply-she would include any receipt she got, and claim her portion on the claim form.  

We also have a few still married couples with us who work for the same company and their company has put a cap on monthly daycare reimbursements, so she submits the cap each month from her account and he submits the cap each month from his account.  Either way, they can make it work.  

I know this is getting long, so let me just tell you about my experience.  I have an account through my company but my ex does not have one at all.  When I submit receipts, I claim my portion and have the secretary sign off on the amount at the preschool--my ex doesn't even know I have an account, but that's okay.  Might be a bit confusing in my explanation, but if you need clarification, please ask!

Quoting M4LG5:

I really love the dependent care flex plan and am trying to get a friend on it but she shares custody of their daughter.  How can that work for both of them to use the dependent care plan with their company?


mumsy2three
by Shauna on Aug. 6, 2012 at 10:57 PM

We have flex plans (medical and childcare) through our employer. I don't use it b/c I honestly don't completely understand it. I get that you can have pre taxed money taken out of your check and put into an account but what is the best way to decide how much to have taken out of you check for medical purposes (I don't have daycare costs anymore) and how do you get the money that is in the account out to pay for what you need to pay for?

mumsy2three
by Shauna on Aug. 6, 2012 at 10:58 PM

What is the best and worst part of the job?

mumsy2three
by Shauna on Aug. 6, 2012 at 10:59 PM

How long have you worked for the company?

IBNeaters
by Member on Aug. 7, 2012 at 12:03 AM

For the best way to figure out how much to take out, I would recommend to start small because, right now, if you don't use it, you lose it.  Most of the time, though, there is a grace period, usually 60-90 days after your plan year end, to use all of your funds.  You can use the money with no issue on most dental expenses (no toothpaste or toothbrushes or bleaching kits--think fillings, check ups, crowns, etc), prescription eye glasses, contacts, eye exams, medical exams, all prescriptions and chiropractic/acupuncture appts.  For over the counter meds, you will need to get a prescription from your doctor.  For vitamins/supplements/massage therapy/weight loss programs, you would need to get a detailed rx from your doctor including specific medical condition being treated.  For my company, if there is a question on supplies, we look at fsastore.com and go by the icons.  The icons are outlined on the website as to what type of prescription, if any, you would need in order for the item to be eligible.  

As to how to get the money out of your account, most companies use debit cards that they issue to participants.  For most places, you may simply swipe the card for eligible items and the money comes straight out of your account, but be sure to keep all receipts which must include date of service, services or items purchased and amount.  There are some places, like Walgreen's, Target and Costco that will automatically approve without the need for receipts, but it's always best to be on the safe side and retain all receipts.  If you do use the debit card on a non-qualified expense, you will be expected to repay that out of your own pocket, so be sure to check with your company about what's eligible and what's not.  

If they don't offer the debit card or if your card is on hold for some reason, simply pay for the expense out of your pocket and submit the expense on a claim form, individually itemizing all dates of services (don't lump expenses together, makes processing your claim more difficult and time consuming, so it will delay you getting your money back)  Again, attach receipts and include receipts with dates of services, services or products purchased and amount.  And, if your item needs an rx, include that as well.  Usually, if you make sure you have all the correct documentation like itemized statements and receipts with product description, you're good to go and should receive reimbursement fairly quickly.  Our company prides itself on getting the claim processed and the check issued within 24 hours, but companies vary.  

Just remember, as long as the products or services were purchased within your plan year or before the grace period, and we can see the actual date of service on receipt, it's fairly easy.  But if you don't get receipts in by the grace period, chances are you won't see that money again.  So be diligent.   

Quoting mumsy2three:

We have flex plans (medical and childcare) through our employer. I don't use it b/c I honestly don't completely understand it. I get that you can have pre taxed money taken out of your check and put into an account but what is the best way to decide how much to have taken out of you check for medical purposes (I don't have daycare costs anymore) and how do you get the money that is in the account out to pay for what you need to pay for?


IBNeaters
by Member on Aug. 7, 2012 at 12:10 AM

The best part of the job, for me, is solving all the mysteries of problems that might come in.  That and the fact that I get to work in the comfort of my own home with very flexible hours.  

The worst part of the job is really wanting to bend the rules, but not being able to.  Even though I don't have direct contact with participants, I still see all the anger and hate mail from participants who just don't understand what we have to go through to appease the IRS.  I would love to be able to approve a claim from a a participant who has a receipt that's almost correct, but there's one piece of information left out and I can't.  If we get audited and certain information is not there, then that's on us, so we really do need to be picky.

Quoting mumsy2three:

What is the best and worst part of the job?


IBNeaters
by Member on Aug. 7, 2012 at 12:15 AM

I have been working there for over 3 years, but I did start at the very bottom.  I've been processing for about 2 1/2 years and have been a supervisor for about 1 3/4 years.  I have a very high attention to detail and I'm a bit of a perfectionist, so it was easy to move up quickly.  Processors need to be very picky with most things, but also need to use their best judgement about what to do and what not to do.  Even I have someone who double checks my work, as I double check others' work.  (most of the time it's through spot checks)

Quoting mumsy2three:

How long have you worked for the company?


mumsy2three
by Shauna on Aug. 7, 2012 at 8:22 AM

Thank you so much for this information.

I am going to have a gum graft *cringe* done in Sept. and will be paying for part of it out of pocket. I have a couple of other areas that will need to be done as well but we are just getting the worst spot done first. My middle child was just referred to the orthodontist, we pay for the majority of that out of pocket too.

I might have to stop into work and talk about the flex plan account with our HR person and find out how and when I can get one set up as well as whether they use a debit card or other means, but it sounds pretty easy. Thanks again.

Quoting IBNeaters:

For the best way to figure out how much to take out, I would recommend to start small because, right now, if you don't use it, you lose it.  Most of the time, though, there is a grace period, usually 60-90 days after your plan year end, to use all of your funds.  You can use the money with no issue on most dental expenses (no toothpaste or toothbrushes or bleaching kits--think fillings, check ups, crowns, etc), prescription eye glasses, contacts, eye exams, medical exams, all prescriptions and chiropractic/acupuncture appts.  For over the counter meds, you will need to get a prescription from your doctor.  For vitamins/supplements/massage therapy/weight loss programs, you would need to get a detailed rx from your doctor including specific medical condition being treated.  For my company, if there is a question on supplies, we look at fsastore.com and go by the icons.  The icons are outlined on the website as to what type of prescription, if any, you would need in order for the item to be eligible.  

As to how to get the money out of your account, most companies use debit cards that they issue to participants.  For most places, you may simply swipe the card for eligible items and the money comes straight out of your account, but be sure to keep all receipts which must include date of service, services or items purchased and amount.  There are some places, like Walgreen's, Target and Costco that will automatically approve without the need for receipts, but it's always best to be on the safe side and retain all receipts.  If you do use the debit card on a non-qualified expense, you will be expected to repay that out of your own pocket, so be sure to check with your company about what's eligible and what's not.  

If they don't offer the debit card or if your card is on hold for some reason, simply pay for the expense out of your pocket and submit the expense on a claim form, individually itemizing all dates of services (don't lump expenses together, makes processing your claim more difficult and time consuming, so it will delay you getting your money back)  Again, attach receipts and include receipts with dates of services, services or products purchased and amount.  And, if your item needs an rx, include that as well.  Usually, if you make sure you have all the correct documentation like itemized statements and receipts with product description, you're good to go and should receive reimbursement fairly quickly.  Our company prides itself on getting the claim processed and the check issued within 24 hours, but companies vary.  

Just remember, as long as the products or services were purchased within your plan year or before the grace period, and we can see the actual date of service on receipt, it's fairly easy.  But if you don't get receipts in by the grace period, chances are you won't see that money again.  So be diligent.   

Quoting mumsy2three:

We have flex plans (medical and childcare) through our employer. I don't use it b/c I honestly don't completely understand it. I get that you can have pre taxed money taken out of your check and put into an account but what is the best way to decide how much to have taken out of you check for medical purposes (I don't have daycare costs anymore) and how do you get the money that is in the account out to pay for what you need to pay for?



Add your quick reply below:
You must be a member to reply to this post.
Join the Meeting Place for Moms!
Talk to other moms, share advice, and have fun!

(minimum 6 characters)

close Join now to connect to
other members!
Connect with Facebook or Sign Up Using Email

Already Joined? LOG IN