Q. If I am age 65 or older when I retire from ORNL, which coverage will I be eligible for?
A. When you retire at age 65 or older, you are required to enroll in Medicare Part A & Part B and you will become eligible for the Medicare Supplement plan with ORNL Rx coverage and the HRA.
Q. If I retire before age 65, which coverage will I be eligible for?
A. If you are not yet age 65 and retire, you will be eligible to participate in your existing coverage. Once you reach age 65 you will no longer be eligible for such coverage. You are required to enroll in Medicare Part A & Part B and you will become eligible for the Medicare Supplement plan with ORNL Rx coverage and the HRA.
Q. What is a Health Reimbursement Arrangement (HRA) and what expenses can I submit?
A. An HRA is employer sponsored health coverage in which a single account is established for the eligible retiree and spouse.
The account is credited with benefit dollars that can be used to pay eligible health care expenses such as premiums for plans that work with Medicare. Unused benefit dollars may be rolled over to the next year.
Q. Will the benefit dollars placed in the HRA change in the future?
A. ORNL will continue to evaluate the marketplace to set the allocation amount. The amount placed in the HRA could increase or decrease in the future, and if it does you will be informed of any changes in a timely manner.
Q. Will the HRA funded by ORNL have cash value?
A. No. The benefit dollars placed in your HRA will not have cash value to you, but will be available to reimburse you for eligible medical expenses, including, for example, individual insurance premiums and eligible out-of-pocket medical expenses.
Q. What happens to the funds in the account when I or my spouse dies?
A. If you and your spouse are both over age 65 and enrolled in a medical plan through Extend Health with ORNL Rx coverage, the surviving spouse becomes the account holder, and his or her contributions will continue if he or she remains in the plan. When there is no surviving spouse, the estate has six months to submit claims for expenses incurred prior to the date of death.
Q. Will the HRA funded by ORNL have cash value?
A. No. The benefit dollars placed in your HRA will not have cash value to you, but will be available to reimburse you for eligible medical expenses, including, for example, individual insurance premiums and eligible out-of-pocket medical expenses.
Q. Which health care expenses are eligible?
A. A sample list of eligible expenses is included with this mailing. To view a printable SAMPLE list of the health care expenses that are eligible for reimbursement, visit your Via Benefits online account.
Q. Why was my reimbursement request denied?
A. A reimbursement request can be denied for a number of reasons, including an incorrect or incomplete document or an ineligible expense. If a reimbursement you submit is denied, you can learn why in your Explanation of Payment (EOP), your online account, or by calling Via Benefits to speak to a representative.
Q. What are qualification requirements?
A. Former employees have qualification requirements to access reimbursement funds. Your Benefit Advisor discussed your specific qualification rules during your enrollment call. Should you want to make changes to your current coverage, we encourage you to contact Via Benefits for assistance to make sure that you understand all the implications of making the change. Call Via Benefits for assistance in understanding your qualification requirements.
Q. How long does a reimbursement request take?
A. Once your request is approved, you should receive your reimbursement within fourteen (14) days. If you have elected direct deposit, your reimbursement should be issued within three (3) days of the request approval. For quicker access to your reimbursement, sign up for direct deposit online, or use the enclosed direct deposit election form.
Q. What is an Explanation of Payment (EOP) Statement?
A. Each time Via Benefits processes a request for reimbursement, you will be sent an Explanation of Payment (EOP). This statement includes a summary of your paid reimbursements, available balance, and the amounts you have been reimbursed. A check will be included with the EOP for those without direct deposit. The EOP will list the reason for denial when a reimbursement request is denied.
If you have not received or are unable to locate an EOP, contact Via Benefits. Use the phone number listed in your Welcome Letter.
Q. What is Automatic Premium Reimbursement?
A. Automatic Premium Reimbursement allows you to obtain reimbursement without submitting a monthly reimbursement request form. You may activate this feature, if it is available for the plans that you selected, in your online account or through Via Benefits Customer Service. Once you have elected to receive Automatic Reimbursement, you do not have to submit requests for these expenses in order to be reimbursed.
To verify whether or not you chose Automatic Reimbursement, please refer to the Selection Confirmation letter you received from Via Benefits shortly after your enrollment call. You can also check by using your online account or call Via Benefits to speak to a representative.
Q. How long does Automatic Premium Reimbursement take?
A. Automatic Premium Reimbursement is not intended to be the fastest way to be reimbursed. It is intended to remove the burden of submitting monthly premium reimbursement requests.
The majority of automatic reimbursements will arrive in the second month following the start of your plan. The first reimbursement will usually include the first two months of premium payments. Timing depends on your specific insurance carrier/health care provider, when your premium payment was received, and when your policy was issued.
Once Automatic Reimbursement begins, it will usually arrive about the same time each month. This may vary depending on when your premium payments to your carrier are made and the timing of the files being sent to Via Benefits.
Q. How do I authorize someone of my choosing to assist me with my reimbursements or access my information?
A. An Authorization to Release Protected Information (ARPI) form allows you to designate someone of your choice to see your allocation and funding balance, submit reimbursement requests, and check on the status. This permits the person you designated to speak on your behalf without your presence on the telephone.
To print a copy of the ARPI from your online account, go to the Funds & Reimbursements section and select the File Reimbursements Requests link. Next, select the Resource Center tab where you will find the list of available forms including the ARPI form to download and print. You can also call Via Benefits, and we will send you a copy of the form. Once completed, send it to Via Benefits using the contact information on the form. You may cancel this authorization at any time by calling Via Benefits.
Q. Who do I contact if I have questions?
A. If you have questions that are not answered in this guide or online, or if you simply prefer to speak to someone, Via Benefits’ trained representatives are always happy to hear from you.
Our Customer Service Representatives are available Monday through Friday, from 8 a.m. until 9 p.m. Eastern Time. Call us using the toll-free phone number printed in your Welcome Letter.
To direct your call accurately, the Via Benefits telephone system may ask you to select from a menu of options. If you are calling about the status of an Automatic Reimbursement payment, select option two. If you are calling with questions about your funding account or requests, select option three.
To verify your identity, you may be asked a few questions before you are connected to a representative. Please be prepared to provide your zip code and the last four digits of your Social Security number.
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