MHM Resources. WinFlexOne Overview

Transcription

1 MHM Resources WinFlexOne Overview

2 WinFlexOne contains enhancements in many areas: Debit card added Plan administration Rollover Claims Website Ease of use Disbursements Contributions Customer Support Importer Security

3 Enhancements Summary Area Debit Card Addition Additional Plan Administration Rollover Enhancement Integrated card processing for Multiplan (FSA/HRA/Trans) spending accounts One system with real time balances and authorization Available MCC (Merchant Category Code) customizations Automated claim substantiation for co-pays and recurring expenses Real time claims status via Web Participant card usage - complete follow up system On line re-payment process for non-qualified expenses Completely integrated with administration system, no duel entry at any level Multi-Plan processing 125,105, 132 FSA/HRA payment sequence automation EOB style checks claims paid identified on each check HRA dollar roll forward control parameters HRA outstanding claim roll forward control Roll Over control by Plan Employer contribution control by plan

4 Enhancements Summary Area Claims Enhancement Claim auto selection of plan type, plan year, and benefits Entry Process has fewer Key Strokes Fewer decisions have to be made by claims operator More Duplicate Claim triggers Global and custom claim types Custom Claim type mapping to existing claim types Custom claim alerts with levels Claim type definition by year Claims Adjustments made to a specific claim, another entry process is not required Downloadable Internet Claims Entry (ICE) Forms Separate claims and disbursement rejection letters Claims denial and history for denied claims (like those where participant has not elected the benefit) Integrated card processing for Multiplan (FSA/HRA/Trans) spending accounts

5 Enhancements Summary Area Web Ease of Use Enhancement Enhanced Employer website tools Complete Web employer enrollment and eligibility system Enhanced participant website tools Incorporation of debit card information PSP website for administration monitoring Real time participant user ID Consolidated administrative functions Expanded reporting options Plan independent of year Annual benefits default from umbrella benefit Payroll schedule management with ACH funds transfer creation enhancements Enhanced copy capability 3rd Party disbursement processing External cash management system interfacing Enhanced security roles with assigned duties Enhanced import capabilities more flexible Enhanced and consistent printing capabilities Separate fields for first, middle initial, and last name of participants Enhanced viewing options for contribution, claim, and disbursement worksheets

6 Enhancements Summary Area Disbursements Contributions Enhancement Automatic Rejection of claims that cannot be paid Disbursements records posted prior to check writing Check printing is a specific job function and a secured right Dual Administrative sign-on can be required for check printing more security Disbursement Schedules may cross plan years and plan types Disbursement schedules only need to be created once Multiple Plans and Plan Years may be posted simultaneously Posted Worksheets are not deleted and can be reprinted Checks can be queued up to printer at a later time. EOB style check Schedule creation and management by actual dates of pay Posted Worksheets are not deleted and can be reprinted Schedules created by Pay Cycle can be used year after year because only benefits in Current Plan Years are considered

7 Enhancements Summary Area Customer Support Module Importer Security Enhancement Separate module to facilitate transferring between client support and processing duties Direct access to employer and employee Web sites Complete employer and employee information PSP Web site allows real time reset for employee and employer Web sites Access to employer and employee reports Supports multiple file formats Allow definitions for field constants Can perform calculations, such as calculating the per pay amount Retains history of imports and error logs Security defined by job role Customizable

8 Objective Understand key concepts in WinFlexOne administration process*: Plan/benefit/year set up Claim type processing Disbursement & checks Customer support Banking Options * Separate overview course for the take care debit card

9 Plan/benefit/year setup The organization of plans, benefits and years is improved: Setup minimize on-going maintenance

10 Plan/Benefit/Year Set Up 4 steps 1. Establish the Plan 2. Establish Benefit (default)

11 Plan/Benefit/Year Set Up 3. Establish year specific & set the benefits that are applicable 4. If necessary, modify the benefit defaults for the specific year

12 Claim Type processing Global claim types allow easy interchange of data with the debit card authorization Claim types allow the system to determine which benefit can pay and in what sequence Ability to customize claim types However, they must be mapped to one of the global claim types

13 Claim Type Definition Global claim types pre-defined* Then Link the claim type to benefits that can pay them and define the benefit pay sequence * Custom claim types may be created which map to the global claim types

14 Claim Type Processing 1. Claim comes in - Employee - Date of service - Description - $ amount 2. Operator assigns a claim type: Medfee 3. WF1 determines which benefits can pay and how much Claim types Rx Medfee Medfee Meddeduc Depcare Benefit & pay sequence 1. FSA Unreimbursed medical 2. HRA 3. Dependent Care Benefit & pay sequence $500 $200 $800 For example: If qualified medfee claim for $450, it would pay from the FSA benefit If qualified medfee claim for $750, $500 would pay from the FSA benefit and $200 would pay from the HRA benefit, and $50 would be pended.

15 Claim Entry Operator no longer has to determine the benefit to enter Instead, simply enters the claim type easier faster

16 Disbursements Disbursement and check print are separate processes Run disbursements Print checks later Re-print checks if necessary

17 Claims & Disbursement tie Claim - Employee - Date of service - Description - $ amount One claim can have multiple disbursements For example: dependent care Check/Disburse Claims One disbursement can pay multiple claims And cross benefits and plan years Check/Disburse Reduces the number of questions and calls. Convenient for the participant to see the information on the check and available for customer service.

18 Checks Check stub contains the claims included in this payment, and the benefits paying.

19 Customer Support Easier access Communication history Additional information Direct web data access

20 Customer Support Admin & Customer Support screens are available at the same time for faster & easier customer support

21 Customer Support Accessible communication History - SSN - Reference ID

22 Customer Support Service representative sees what the participant sees Instant access to debit card authorization information

23 Customer Support More information available, organized by tabs and line item drill down capability

24 Customer Support Direct Access to Employer information from Employee customer service screen

25 Customer Support Access eflex or debit card screens directly from WF1 Employer customer service screen

26 Banking Options 1. Use Service Provider s Account for Processing a. Regular b. Consolidated Banking option (future) 2. Use Employer s Account for Processing

27 Use PSP s Account - Regular Designed for a pre-funding of disbursements strategy by the PSP. Contributions (payroll deductions) are acquired based on the payroll schedule and held in the PSP s account. Contributions: Option Pull Check Wire ACH Disbursement Check EE direct deposit Debit Card Sent by Winflex ER ER ER Disbursements: Form Automated ACH Paper Electronic Electronic From account From account Company banking Company Funding Acct ER account ER account ER account Cash Management: 2 Check Disbursement Cash Management: 3 ACH Disbursement Cash Management: 4 Debit Card Funding To account Cash Mgmt 1 Contribution Acct PSP account PSP account PSP account To account n/a EE account MHM settlement account

28 Use PSP s Account - Regular

29 Use PSP s Account Consolidated Banking (Future) Designed to support a post disbursement funding strategy by the PSP. All disbursements are made from a single PSP account and the system then creates the ACH transaction to automatically pull the funds from the Employer s account the following day and an notification to the employer is automatically sent at the time the ACH is created. Disbursements: Disbursement Check EE direct deposit Debit Card From account Post Disbursement Funding: Disbursement Check PSP Consolidated Account* PSP Consolidated Account* PSP Consolidated Account* From account Company s Funding Account To account n/a EE account MHM settlement account To account PSP Consolidated Account* EE direct deposit Debit Card Company s Funding Account Company s Funding Account PSP Consolidated Account* PSP Consolidated Account* * Account must be the same as Cash Management 6 Consolidated Banking and contribution method = pull

30 Use PSP s Account Consolidated Banking (Future)

31 Use Employer s Account for Processing Designed to support a PSP strategy of disbursements are made directly from the Employer s bank accounts. Disbursements: Disbursement Check EE direct deposit Debit Card From account Company banking Account to Write Checks from Company banking Account for ACH Payments Company banking Account for Debit Card Note, this must be a PSP account number at this time. Requires written consent from MHM Resources to designate an employer account. To account n/a EE account MHM settlement

32 Use Employer s Account for Processing

33 Summary Plan/benefit/year set up Claim type processing Disbursement & checks Customer support Banking Options