In episode 5 of the Bright Side of Benefits, host Becky Seefeldt sits down with BRI’s Participant Services Leader Dave Stehler to dive into some of the common questions that participants have regarding their consumer-driven benefits.
Listen to Episode 5 below:
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Want more on this topic? Listen to our recent webinar, How to Keep Participants Informed All Year Long, which Becky and Dave discuss moving from an Open Enrollment “blitz” to an ongoing communication strategy.
TRANSCRIPT – EPISODE 05: Common Questions Regarding Consumer-driven Benefits
[Becky]
Hi, I’m Becky Seefeldt here with another episode of the Bright Side of Benefits. This is a series for benefits professionals and consultants where we talk about the latest news and happenings in employee benefits. I am the VP of Strategy of Benefit Resource, a third-party administrator headquartered in Rochester, New York. For 20 years, I’ve been dedicated to the education and advancement of consumer-driven benefits.
I’m here today with Dave Stehler. Dave is a leader in our Participant Services Team at Benefit Resource. He serves as a champion for our participant experience and driving initiatives, uh, which continue our commitment to personalized support. Dave recently joined me, uh, for our webinar on how to keep participants informed. He enjoyed it so much that he decided to come back to us. Hi, Dave.
[Dave]
Hey Becky. Thanks. Glad to be here.
[Becky]
So today we’re going to dive into a topic that I think is near and dear to your heart. Uh, some of the common questions that participants have regarding their consumer-driven benefits. And just for some context, on average Benefit Resource receives about 4.6 calls per 100 participants per month.
Uh, this can obviously vary based on the time of the year, how long the plan is in place, the complexity of the plan, and how actively the plan has been communicated. But overall, there’s certain things that we see as common questions and common areas that people are concerned with. Uh, let’s start with our first area.
#1 Reason for Calling: Claims (23% of Calls)
So claims obviously, FSAs and HRA claims are top of mind. 23% of all calls are regarding something with claims. Uh, can you give us some perspective on what are the types of things that people are calling about regarding claims, and what are some opportunities to really improve or optimize their experience?
[Dave]
Yeah, happy to, and there’s, there’s some different scenarios that, uh, that come into play:
- Looking ahead of time before they’re going to incur an expense to find out what’s eligible to claim.
- Looking for deadlines to submit or to incur their expenses.
- Have already done something and they’re trying to figure out, what happened, and what went wrong. (e.g., what’s the status of my claim after I’ve submitted it)
- People who get denied for their claim. Whatever reason, whether it’s related to the documentation was missing some, uh, some key items that we need to process, or it’s not eligible with the plan that they have, or it’s not eligible because of missing a deadline to submit for that type of expense.
What we can really do on the claims side of things is make sure that people are aware of where they can check things themselves.
So the status of their claim, submitting their claim – that can all be done online or through the mobile app.
There are also alerts and notifications that make it much easier for someone to not have to reach out to somebody. We basically will ping you when your claim has been approved and it’s generating a reimbursement if you sign up for claim status notification. As well as, you know, seeing that your balance has changed on your account because of cleaning is being reimbursed out to you.
Um, also just trying to figure out most people don’t care as much about when they’re getting their money for their claim, as much as they are looking for confirmation that their claim is being approved and being paid and where it’s being paid. And especially with the post office and mailing, not being a guaranteed “you’re going to receive your check in two days” based on location or, your post office in your area. And you know, making sure that people are signed up for direct deposit so that it is much more concrete timing, to get their reimbursements and not have to jump through hoops.
Yeah, have a check at missing in the mail and reach out to us to find out: Did it get paid? When did it get paid? I didn’t get my check. Is the address correct? Now I have to wait for the check to be voided and reissued, um, that, you know, direct deposit solves for that. And the notification alert to verify that your claim is getting paid out is another confirmation that’s automatic.
But in terms of the, you know, what’s eligible and what are my deadlines. That’s something that just educating on, uh, your plan highlights, you know, this is going to outline very simplistically what’s eligible. When can I incur the expenses; who can incur them? You know, if it’s a family member, as well as what’s my deadline to submit this and what happens to my money, if, uh, when the plan year ends or if I separate; they’re all related to claiming their money and utilizing their benefits.
Um, so those are things that you’re really providing the upfront information to really just set the person on the right stage so that they’re there knowing where they can go or what they can sign up for automatically, um, to get these resources so that really they can get them whenever they want. So, you know, through our website or through the mobile app, rather than relying on having to reach out to somebody to get those answers.
#2 Reason for Calling: Benefits Card (15% of Calls)
[Becky]
In addition to claims, we also hear issues or questions about the benefits card that often comes with their plans, and represents about 15% of calls. So what are some of the things that people are asking about in regards to their cards associated with their benefits plans?
[Dave]
Yeah. And this is another thing that can really change based on the life of the plan. So new account users, you know, or a new client comes on board with us and you hire a bunch of people and they all onboard together.
There’s the initial, “when is my card going to arrive in the mail and how do I activate it?” Or you know, “was my address correct?” Um, and just getting the card ready to go so that, you know, kind of related to the claims topic of “what can I use my card for when is my deadline to make sure to use my card for the right plan year.”
Um, but the biggest thing is really when your accounts are getting set up, getting those initial notifications, having email on file with us so that we can send out. It’s more of a welcome notice that, you know, something’s coming from us, uh, you know, so you don’t throw away the envelope, not knowing, you know, not opening it, looking like it’s junk mail potentially.
But even just knowing, “is there a card associated with the plan?” There’s people who are submitting claims because they didn’t know they had a card because they never came in the mail or they didn’t know that that’s what the card was for. So, they tossed it. And then there’s really, “how to activate your card“. You can call us; there’s a sticker on the card to activate. Or you can actually go online and activate your card, or even order replacements yourself, through the website that people just aren’t as aware of.
So a lot of the card items are initially upfront when there’s new account holders. That’s where they’re kind of getting the “Where’s my card? How do I use it?”
And these types of benefit accounts, you know, you can set up your card with these new mobile wallets. So like, Google Pay, Samsung Pay, Apple Pay. These cards can link to them. However, you need to have the physical card with you to obtain the card numbers, to attach to the accounts. And it’s not one of those credit cards that you can get a digital card number. So there’s people who will sign up and then think they can start accessing the card immediately when it’s really, you got to wait for the card to arrive in order to start using it.
Now, beyond that, that kind of covers any account that has cards. But when you dig into like a Medical FSA or certain HRAs, substantiation comes into play. So people who want to use their cards, there’s certain times where they have to submit a receipt after they make a payment to verify that the purchase was eligible. That is, the card can’t recognize where you’re going. You know what the merchant name is, the type of merchants, and the amount that’s being charged.
But not always is it going to know exactly what expenses are eligible. And there’s a lot of merchants that can crossover into, you know, dual-purpose land, where not everything that they offer or sell is. Where we have to ask the participants to send us that proof of, “Hey, this was an eligible expense, check it off the list.” You know, the provider gets paid right away. So when we send out a notification alert saying, “Hey, you just made a recent purchase. We need an itemized receipt or invoice or EOB from insurance to verify what was purchased.”
Some people will think that, “oh, did they get paid?” Or “the provider’s not going to get paid until I submit this receipt”. These are generated after a transaction that’s successfully paid to a provider just after the fact, let’s make sure it was eligible. So the card is kind of an on your honor system. You’re usually paying out of pocket, submitting a claim, or waiting to get reimbursed. You know, the expense was had, it was verified. It was eligible. Then you get your money. The card is like an upfront access to your account balance. It’s ease of use. You’re able to pay your provider and then prove after the fact when needed.
Because we do have I believe, in the upper 90 percentages, of auto adjudication. So not even needing you to send in proof of your expense, you just swipe your card and go. So that is another common item; we only need you to send us your receipt when you use the card, when we reach out to you and bug you for. It’s also visible online or through the mobile app.
We send out email and letter communications when needed. Um, so just the, “why do I need to submit a receipt for my card transaction? Why don’t you reach out to the provider for me?” Um, you know, with HIPAA and PHI regulations, when we do need receipts to verify a purchase was eligible, we can’t call your doctor because they legally can’t tell us what your expense was.
So that’s where it falls on the participants to really be that middleman of when proof is needed for what you pay for with. You’re the one who’s got to get that from the provider. If you don’t have it already and submit that over to us. And then we’re just checking it off the list on the side. Um, those are, those are the biggest things with the card.
You know, the same thing with what’s eligible to use the card and the deadlines, like I said, with the claim. So their plan highlights are going to really outline what’s eligible, when to submit, when to use, when you’re switching from one plan to another. Another big question that comes up right at the busiest time of year, year-end, or the beginning of a new year.
And what we do is the same cards, get loaded with each plan year with new funds, so that it is much more of a one-card solution. You know, if you have multiple plans that have cards, we’re often able to link. And the card knows where you’re making a purchase and what type of purchase it is to use the right funds.
So if you have a Mass Transit Commuter Account and a Medical FSA, the card knows you’re going to a subway station versus a pharmacy. So you don’t have to worry about, you know, having multiple cards with us and using the right one to access the right funds. Um, the card is smart in that sense.
#3 Reason for Calling: Web (14% of calls)
[Becky]
Some great tips on kind of using the card and reminders for kind of year to year.
Uh, one of the things that I think you indicated both in kind of the claims and, and with the card is all the resources that are available to them through BRIWEB and the mobile app, and how they can really use those resources to improve their overall. But we see from a web perspective that about 14% of people are calling with regard to things on the web. And if I understand correctly, the biggest reason people call is just how to get logged in.
Can you give us some tips on what employers can do to help, um, make sure that people are getting logged in? And uh, improving their experience off the bat?
[Dave]
Yeah, definitely. And, you know, at all ends of the spectrum in terms of, you know, location, age, plan type, there’s really a feeling of everyone wants to try and do it themselves.
So trying to get people registered online is really important, you know, and it sets the right stage because there’s resources, there’s options to submit claims, set up these notification alerts. And new users, because this is a secure portal and there are medical type accounts or just you know, money involved, participants are required to enter in:
- Their company code, which is unique to each client with us
- Then, their specific member ID number, which it’s usually either their social security number or some sort of employee identification number. Whether it’s a security badge number or an employee ID or a payroll number. We need clients help to find out what that member ID is called if it’s not the social security number. Um, because we can call that out in our communications that go out to participants when they’re they’re newly establishing an account.
- And then it’s first name, last name, and your home zip code.
To get registered now on top of that, there’s a validation step of having to receive like a validation code. And that’s going to be sent either by email or by text message as long as we have an email or phone number on file.
So that’s what we rely on. You know, the more demographic information that comes over for new users or the more emails and phone numbers we have on file, the easier it is for people to use those when registering to get set up without having to contact anybody. And once online, that’s where, you know, everything’s at everyone’s fingertips.
We have videos to kind of walk through the websites, um, and the resources are all there. And the mobile app at Bri mobile, it’s the same login information as the website. So you can register on the website and then go straight on the app using the same login information and same vice versa. You can register through the app, um, and then access the web or the.
Another nice thing is, you know, some people don’t want to put too many apps on their phone. You can access the website through your phone, by going to the regular Benefit Resource link. Um, it’s mobile-friendly. So it’s very easy to navigate through everything through your phone since everyone uses their phones currently.
But yeah, once getting registered. So, company code and member ID are where we typically have people having no idea what it is. If we can validate the caller, you know, authenticating them with their personal information, we can provide their company code to them. But that member ID, just for security purposes, we don’t give that out to somebody. We can only confirm or deny what they’re telling us is matching what’s in our system. So there’s plenty of times where we have to refer someone back to their HR when they just can’t figure it out.
That’s one of the biggest things that, you know, it’s frustrating for the caller because they can’t get what they need to know. And then we feel bad on the customer service end of having to kind of deflect the caller back to the employer when we’re the ones who are trying to help each participant with their accounts. So company code and member ID, trying to get that in everyone’s faces initially, is the best way to let someone sign up on their own at their own leisure, and get into their accounts. And then really start utilizing other benefits in the most efficient manner.
Additional Tips for Employees
[Becky]
Sounds like, uh, lots of great options. And I think with that, I do think we are ready to wrap up. Do you have one last tip for anyone before we do wrap it up?
[Dave]
Yeah. I mean, really just, um, making sure you find your company’s plan highlights because that is a one-stop shop of making sure that you know:
- What’s eligible
- When can participants spend the funds
- What’s their deadlines
- If they have a card attached
- Who’s eligible
It really highlights the plan. And trying to get to that is right through their secure online portal. And luckily once you’re able to get through the online portal, that’s where you’ve got access to those notification alerts, signing up for direct deposits, and getting the mobile app downloaded. So it’s all kind of: if you can get to your plan, you’ve made it everywhere else that you need to go.
[Becky]
It sounds like it’s one-stop shop from there.
So I do want to thank you for joining us today. And just a reminder, if you’d like to stay up to date with the latest benefits trends and industry news, be sure to visit us at benefitresource.com and sign up for our blog and newsletters. You can also follow Benefit Resource on LinkedIn.
And we like to close on a bright side. So in honor of Dave, who is our die-hard Buffalo Bills fan, we thought we would incorporate a quote, that seems to be evidence, from a Bill’s perspective.
There’s always next year. Go Bills!
[Dave]
*laughs* Thanks Becky.
[Becky]
You’re welcome. Have a great day.
