Frequently Asked Questions
Yes, requirement defined in Title 74 O.S. Supp. 2000, Section 1371.
Yes, You can Opt Out with proof of other group coverage i.e. you are covered under your spouse plan.
The policy of "cover one, cover all" applies to all dependents, regardless of age.
Children may be insured up to age 26.
A dependent, who is incapable of self-support, and who has a disability that was diagnosed before the age of 26, regardless of age, may remain covered as long as the disability continues and the member remains covered on one of the health plans. Verification of continued disability must be provided upon request.
Contact your Agency coordinator, and complete and submit a Change Form.
No, you chose an HMO, not a Doctor. You must select another Primary Care Physician. You cannot make enrollment plan changes unless a qualified mid-year event has occurred.
Any eligible dependent is allowed coverage on your insurance. For more detailed information on eligibility contact the Empoyee Benefits Department.
Toll Free: 800-219-8115
TDD (Telecommunications Device for the Deaf): 1-405-522-5528
Existing coverage will continue at your current agency until the end of the month of transfer. The agency you transfer to will continue your coverage from the first of the next month. No plan coverage changes are allowed during an agency transfer.
Flexible Spending Questions
a. Under the Internal Revenue Code’s Uniform Reimbursement Rule, you have access to your full Health Care Account pledge after January 1st.
b. IRS Section 105 and 106 refer to Employee, spouse, and dependents. Employees as of January 1st will be making contributions into the plan via salary reduction, and therefore, eligible to receive reimbursement.
Your agency payroll department can change this selection.
a. Weight loss programs require a doctor’s letter of medical necessity and diagnosis. The diagnosis can be obesity, hypertension, etc. The IRS has approved the costs related to the taxpayers weight-loss programs to include the fees to attend periodic meetings. Prescription weight loss drugs are also a reimbursable expense with the doctors’ letter of medical necessity and diagnosis.
b. Diet food items, health clubs, spas, and fitness center dues are not viable treatment options under this ruling. Date of service (attendance dates at meeting) are required. Over the counter weight loss items are not reimbursable.
You can be reimbursed up to your total annual election amount at any time during the plan year (while an active participant). Claims received beyond your annual election amount can NOT be reimbursed.
The date the medical care is provided to the participant (date of prescription, order date of glasses, dentures, hearing aids, etc.), not when formally billed, charged for, or paid. For terminated employees: Date of medical care must be prior to the end of the month of the termination month.
Mileage is figured to and from the qualified medical provider and may be reimbursed. Proof of medical care is required. Beginning January 1st, 2020 the standard mileage rates will be $0.17 cents per mile for the use of a car, van, pickup or panel truck for medical purposes, down from 20 cents in 2019.
The IRS has not yet released the standard mileage rates for 2021 yet. The rates are typically updated in December for the following year.
Internal Revenue Code Section 125 states, “A health FSA administrator must obtain substantiation that this requirement has been met by obtaining a statement from the participant at the time the request for reimbursement is made, that ‘the medical expense has(have) not been reimbursed and I will not seek to be paid or reimbursed by an insurance company or is not reimbursable under, any other health plan coverage or from any other source or used to calculate a tax credit’.”
Yes. Just remember this print out will not show any over-the-counter items purchased. EBD needs the receipt if you purchased over-the-counter items showing the names of the items purchased.
Effective July 1, 2007, the State Treasurer's office mandated every employee should either have direct deposit or a "pay card". Your direct deposit will go to the same bank account as your payroll.
Oldest money pays first. IRS and software rules. If you want to use 2020 expenses to finish off your 2020 account send those in for reimbursement before using any 2021 money. If using the Benny/HealthScope card you must be enrolled with the Benny/HealthScope card in both years for the card to pull from oldest money first then start pulling from your new year funds.
Fax a copy to 1-405-522-1175 along with a copy of the Receipt Request or Denial letter that we sent to you.
Yes. At selected Merchant Codes such as Pharmacies, Doctors, Vision providers. If you purchase your approved Over-the-Counter (OTC) items at IIAS approved Merchants no documentation is required to substantiate the charge. If you purchase OTC items at other locations you will need to send in proof of purchase (receipts) to substantiate the items purchased.
List of IIAS approved Merchants is located at IIAS Merchant List.
No substantiation needed for purchases from the online FSA store at the following merchants: drugstore.com, 1-800-Contacts, or Walgreens.com. Approved items have a check mark by the word FSA.
Yes. Save your Insurance Explanation of Benefits (EOB). When you receive a receipt request letter fax the letter and your EOB to 405-522-1175. When your debit card was swiped it may have been for an estimated amount. The actual amount after insurance payment and any write off amount may be different.
Per the cardholder agreement when you activated the Benny card you agreed to send documentation after the fact, when requested. If your provider overcharged you can have them credit your debit card for any overcharged amount. If your provider credited the Benny card please let us know as that needs to be documented also by an FSA Auditor and is not yet an automated procedure.
Send a check to the Employees Benefits Department with a note explaining what you are repaying and why or attach a copy of the receipt request letter we sent you.
You forgot to take or use your debit card. You want to be reimbursed for mileage. You paid for your purchases with another form of payment.
Please wait until you receive a receipt request letter. Fewer and fewer items require documentation as technology improves and more merchants become IIAS compliant. Just hang on to your documents until requested and fax them in at that time with a copy of the receipt request letter we send you.
The IRS Regulations state you must keep your receipts for 7 years. EBD has been keeping them for you with your paper claims. You will need to keep your receipts for all Debit Card purchases. Also, if we need additional documentation to substantiate your claim you will want to have those receipts handy to fax in to us.
Request the number of additional cards you would like by requesting in writing or by email or service desk. The cost is $10.00 per set of two cards.
12 Months. The plan period is from Jan 1st to Dec 31st. You have an annual election with payroll withholdings for this period. EBD and the IRS are allowing you the additional 2 1/2 months to receive services to assist you in receiving services and avoid you losing any money. Your annual election is still divided by 12 pay periods if you are paid monthly, 24 if you are paid biweekly, and 24 if you are paid semi-monthly.
Yes. Any daycare facility that accepts credit cards will accept this debit card. However, you can only access the current cash balance.
If you have set up a PIN number for your card, you can choose DEBIT. If you have not set up a PIN number then you will choose CREDIT. Please note PIN numbers will not allow cash withdraws.
If EBD and the banking institution is notified within 2 business days you will not be responsible for any charges. If EBD and the banking institution is notified after 2 days you will be responsible for the first $50.00. Replacement cards are $10 per set of two cards. You can dispute a charge up to 90 days after the charge (see the activity dispute form after signing into healthscopebenefits.com.
The IRS and Benny cue up charges requiring documentation. Debit card purchase receipt request letters will be sent to you. They will allow you 4 weeks to return documentation (receipts, EOB's, itemized statements). If receipts requested are not returned your card will be suspended and a letter of suspension will be sent to you.
Per the cardholder agreement some charges require after-the-fact substantiation. You agreed to the terms of the cardholder agreement when you activated the card.
The spouse or dependent. The user of the card will sign the back of the card.
a. A copy of the orthodontist financial contract apportioning the expenses is acceptable. An itemized statement of payment is acceptable. The insurance explanation of benefits is acceptable.
b. You may send in a claim as often as you like or send one claim for the entire year. One claim for 12 months services is allowable and entered as 12 line items, one for each month. The software releases funds as the date of service passes. A new claim is needed each year.
Send in a claim without the EOB and let us deny your claim giving you an additional 180 days to supply the additional documentation.
No. 2021 funds must have services rendered after January 1, 2021. The grace period allows you to use any leftover funds from the previous year with services from January 1st through March 15th, but it doesn't allow you to go backwards. You cannot use new year funds for a service provided in a previous year. Once you are out of 2020 funds you must pay for services with other money not from your spending account.