Beginning the Setup Process

FSA

Implementation Handbook

Albert Lea Office
Alliance Benefit Group
201 E. Clark Street
P.O. Box 1226
Albert Lea, MN 56007-1226
1 800 898-9344
Fax 1 866 808-7823 / Metro Office
Roger B Jorgensen, RHU, REBC
Alliance Benefit Group Services
8220 Commonwealth Drive, Suite 204
Eden Prairie, MN 55344
(952) 253-1259

Welcome!

Welcome to Alliance Benefit Group! We appreciate the opportunity to provide employee benefit services for you and your employees. This handbook is designed to provide an outline of the documentation and information necessary to implement your FSA with Alliance Benefit Group.

Certain portions of this handbook should be completed prior to the initial submission to Alliance Benefit Group. We will continue to use the handbook as a guide and reference tool throughout the setup and implementation process.

Beginning the Setup Process

1.  In order to begin the setup process, we ask that you first review and complete page 4 of this document and the Plan Document Checklist.

2.  Once you have completed page 4 of the handbook and the Plan Document Checklist, please return both documents to Stacie Ravenhorst at .

3.  Participant enrollment data should be entered on the enrollment spreadsheet template and returned via our secure email connection as explained on page 5.

Need help? We would be happy to assist you with completing page 4 of this handbook and/or the Plan Document Checklist. Simply complete what you are able to and then contact Stacie Ravenhorst at (800) 898-9344 or .

Once Alliance Benefit Group receives the completed setup pages you will be contacted by our Implementation Specialist to discuss the following:

·  Plan design and setup details

·  Submission of enrollment data to ABG

·  Funding options for reimbursement payments

·  Processing schedule for claims

·  Welcome communication for participants

·  Ongoing administrative matters (i.e. new enrollees, mid-year changes, terminations, etc.)

·  Any questions you have at that time

Important: The Plan Document must be completed and adopted before your plan becomes effective. In order to accomplish this, ABG must receive the completed Plan Document Checklist 3 weeks prior to your plan’s effective date.

Please make sure that you complete all setup documents carefully and completely in order to ensure that your plan is properly set up with Alliance Benefit Group. If you have questions when completing these documents, please call our office at 1-800-898-9344.

We look forward to working with you!

I. Alliance Benefit Group Service Directory

Consulting/Setup Assistance

(Please contact your broker or agent, as applicable.)

Roger Jorgensen, RHU, REBC

Marketing – FSA/HRA/HSA/COBRA

8220 Commonwealth Drive, Suite 204

Eden Prairie, MN 55344

952-253-1259

Implementation Services

Stacie Ravenhorst, CFC

Implementation Specialist for FSA/HRA/HSA

201 East Clark Street

Albert Lea, MN 56007

800-898-9344 ext 1189

Sadie Wuerflein, CFC

Account Executive for FSA/HRA/HSA

201 East Clark Street

Albert Lea, MN 56007

800-898-9344 ext 1128

Plan Administration Services

Michelle Hintz, CFC

Supervisor of FSA/HRA/HSA Administration

201 East Clark Street

Albert Lea, MN 56007

800-898-9344 ext 1177

Participant Customer Service

Alliance Benefit Group Customer Service

Toll Free Phone: 855-866-8060 (Live operators Mon-Fri 7:00 a.m. – 6:00 p.m. Central Time)

Toll Free Fax: 866-808-7823

Participant Website: www.abgaccess.com

Your plan will be assigned an administrator by the Implementation Specialist – you will receive this administrator’s contact information once setup is complete.

II. Employer Information

Employer Name: / Today’s Date:
Street Address:
City: / State: / Zip:
Federal Tax ID: / State of Incorporation:
Type of Employer Entity (please check one):
C Corporation S Corporation Partnership Sole Proprietorship Limited Liability Company
Non-Profit Organization Government Church
Primary Contact:
Phone: / Title:
Email:
Fax: / Billing Contact:
Phone: / Title:
Email:
Fax:
Payroll Contact:
Email:
Phone: / Payroll Frequency: Please Select...WeeklyBiweeklySemimonthlyMonthlyAnnual
Date of 1st payroll deductions:
/ Is Payroll Outsourced?
Yes
No
If yes, please identify vendor:
Is COBRA Outsourced?
Yes
No
If yes, please identify vendor: / Broker (Agent) Name:
Broker’s Company Name:
Broker’s Phone:
Broker’s Email: / Additional Contact(s) for Broker:
Name:
Phone:
Email:
FSA Information
Type of plan:
Full Flex Plan
Premium Only Plan / Benefits offered:
Health FSA
Limited Purpose FSA
Dependent Care FSA
HSA
Transit
Individual Premium Reimb. / Number of eligible employees:
Number of Reimbursement Accounts:
Plan Year Begin: End:
Mid-year Takeover Yes No
Debit card provided: (FSA Only)
Yes
No / Debit card provided for:
Health FSA
Dependent Care FSA / FSA Contribution Annual Maximum:
Processing frequency:
Monthly
Semi-monthly
Bi-weekly
Weekly
Daily (funding option 3 only)
Other / 2 ½ Month Grace Period: (FSA)
Yes
No
If yes:
2 ½ months
Other
For:
Medical Dependent Care / Claims run out period:
(after plan year end or grace period end)
30 days
60 days
90 days
Other
Reimbursement payments drawn on:
Employer’s Acct
ABG Acct / If ABG’s Acct:
ABG pulls funds
Client pushes/wires funds
Client sends check (ABG will hold participant checks) / Is a new plan document required:
Yes
No
Additional Comments:

III. Participant Census Data

The following census data is required for the setup of your participants. This data should be submitted to Alliance Benefit Group in an Excel spreadsheet. Each bulleted item represents a separate column required in the spreadsheet. If a specific column does not apply, (i.e. division) simply leave that column blank.

Below is an example of how the spreadsheet should look. (Note: this is only a portion of the spreadsheet.)

FSA Spreadsheet Columns Required

·  Social (with or without dashes, no spaces)

·  Last Name

·  First Name

·  Address 1

·  Address 2

·  City

·  State

·  Zip Code

·  Email Address

·  Date of Birth (MM/DD/YYYY)

·  Date of Hire (MM/DD/YYYY)

·  Annual Declared Amount – Dependent Care FSA

·  Debit Card (for Dep Care FSA) Y/N

·  Annual Declared Amount – Health FSA

·  Debit Card (for Health FSA) Y/N

·  Annual Declared Amount – Limited FSA

·  Payroll Deduction Frequency (Monthly, Semimonthly, Biweekly, etc.)

The following columns are only required for participants electing to use direct deposit:

·  Bank Account Number

·  Bank Routing (ABA) Number

·  Checking/Savings

How to submit census data to ABG

The enrollment spreadsheet should be submitted to Alliance Benefit Group upon completion. Since this spreadsheet includes confidential information, you will need to submit via secure email connection.

You will be contacted by our Implementation Specialist once you have returned pages 4-5 (above). You will then receive an email invitation to join our Secure File Transfer where you will submit your enrollment spreadsheet.

You should use this Secure File Transfer to submit enrollment data, as well as other ongoing data that is confidential in nature (i.e. information including Social Security numbers).

IV. Funding Options

The FSA employee contributions will remain in the employer’s bank account until they are needed for the reimbursement of claims. Following are the options available for funding claims payments for FSA. Please select the option you prefer.

Option 1 – ABG Account and ACH Pull

Reimbursement payments are drawn on Alliance Benefit Group’s bank account. The employer is sent a payment detail report via email. ABG then pulls the total amount reflected on the payment report from the employer’s bank account.

Checks and/or direct deposit notices are immediately mailed to the participants’ homes and the funds are withdrawn from the employer’s account one business day after they receive the payment report.

Option 2 – ABG Account and ACH Push or Wire

Reimbursement payments are drawn on Alliance Benefit Group’s bank account. The employer is sent a payment detail report via email. The employer then initiates an ACH push or wire transfer in the amount reflected on the payment report.

Employees’ reimbursement checks and/or direct deposits will not be released until Alliance Benefit Group receives funds from the employer.

Alliance Benefit Group Account Information

Bank Name: Security Bank Minnesota

Account Name: Alliance Benefit Group Pay Plus

ABA Routing Number: 091908399

Account Number: 124149

Option 3 – Employer Account

Reimbursement payments are drawn on the employer’s bank account using check stock provided by Alliance Benefit Group. Checks can be printed with employer’s choice of 1) a signature electronically provided by the employer, 2) a signature provided by Alliance Benefit Group, or 3) no signature so employer can personally sign and distribute. If an Alliance Benefit Group signature is used arrangements must be made in advance with Employer’s bank.

The employer is sent a payment detail report via email. Checks and/or direct deposits are immediately released to participants or directly to the employer if a signature is required.

Administrative Fee EFT Transfer Information

The monthly administrative fees will be automatically paid via EFT (wire) transfer. You will receive an invoice each month via email and the EFT will occur 10 days after you receive that email.

Funding Requirement for Debit Card

Prefund Requirement

Evolution Benefits, our debit card vendor, requires that employers provide 5% of Health Flexible Spending Account (FSA) funding at the start of the plan year. This is known as the prefund requirement and this balance must be maintained throughout the plan year.

For example…

An employer has 30 employees enrolled in the Health FSA and their total annual elections add up to $90,000. 5% of $90,000 is $4,500 so the prefund requirement is $4,500.

Why does the debit card vendor require the prefund?

Because Visa debits their account daily for any transactions that take place, however, the card vendor only debits the employer’s account once per week.

Weekly ACH Debits

In addition to the minimum funding requirement, the employer will receive a weekly summary of the debit card transactions that took place during the prior week. This report will arrive via email every Monday and the debit card vendor’s bank, Bancorp Bank, will pull the total amount of these transactions from the employer’s bank account the following day.

Who will receive the email each week?

The email can go to as many individuals as the employer requests. Simply let your plan administrator know who should receive these reports and they will be set up accordingly.

Getting started

The first step in getting started is completing the Authorization for ACH Debits form for Bancorp Bank, the debit card vendor’s bank. This form should be completed and submitted to Alliance Benefit Group, along with a voided check. If your account does not have checks, please provide a spec sheet or letter from your bank verifying the account and routing numbers for that account.

V. Plan Document Requirement

Plan Document for FSA

Flexible Spending Accounts are part of a Section 125 Cafeteria plan and they require a plan document and summary plan description (SPD). The SPD must be distributed to all employees who are eligible to receive benefits under the plan. The plan document must be adopted by the employer before the plan becomes effective.

Alliance Benefit Group can provide a new Section 125 plan document (see applicable fees in your proposal) if needed. If you have a plan document in place, and it is current and up-to-date, you may continue to use that document. However, ABG will not be able to update that document with any plan changes. Remember, It is critical the plan document is up to date and includes all items IRS regulations stipulate must be in a Section 125 plan document.

Please notify the Conversion Specialist if you need a new Section 125 plan document. ABG must receive the completed Plan Document Checklist three weeks prior to the plan’s effective date.

VI. Ongoing FSA Administration

Account Manager

You will be assigned a designated account manager who will be responsible for managing your FSA plan. Your account manager will serve as your primary contact at Alliance Benefit Group and will keep you informed of any important information regarding their plan.

Employer Portal Website

The employer portal website allows you to access employees’ account information, add, update or terminate employee coverage, update employees’ demographic information and more. You will be provided an Employer Portal QuickStart Guide which includes your login instructions and detailed instructions for navigating the site.

Terminated Participants

You should notify your account manager of employee terminations as soon as possible. The most convenient way to do this is on our employer portal website. The procedure after termination is dependent upon plan design, but in most cases participation ceases and only claims incurred prior to termination are eligible for reimbursement.

Administrative Invoices

Alliance Benefit Group processes invoices for administrative fees on a monthly basis. The setup fee is a one-time per participant fee, and will be included on the first invoice. It will also be charged as new participants are added to the plan.

Invoices are sent via email and can be directed to multiple contacts, if needed. Payment for monthly invoices can be made by automatic EFT which occurs ten days after you receive the invoice.

Customer Service

Alliance Benefit Group is happy to assist you and your employees with any questions, requests or concerns regarding our services. Our customer service representatives are available Monday through Friday from 7:00 a.m. to 6:00 p.m. Central time at (855) 866-8060 or .

Participants can access their accounts online at any time. Online, they will have the ability to review their balances and account history, submit claims and debit card receipts, update personal information and email Alliance Benefit Group customer service. You can also access participants’ account information online through our employer portal website.

Use of the Benny™ Prepaid Benefits Card

If your FSA participants are using the Benny card, they will likely receive periodic requests to submit documentation for their purchases. It is important that new participants are made aware of this and other pertinent information related to the use of the card. Please see the enrollment material or your ABG account manager for detailed information regarding the use of the Benny card.

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