How Does Take Command Handle Reimbursement Operations, Allowance Limits, and Timing Issues?
Take Command’s reimbursement operations are designed to ensure employees receive timely and precise reimbursements for eligible expenses. Below is an overview of the key workflows, allowance policies, and common troubleshooting solutions to guide you.
Overview of Reimbursement Workflow
Take Command collaborates with employers to facilitate reimbursement processes. Here are the primary steps:
Submission of Documentation: Employees must provide proof of eligible coverage and submit claims through the member portal.
Approval of Claims: Only approved claims are processed. Ensure that all claims show an "approved" status before the employer’s report generation date.
Employer-Generated Report: Take Command compiles monthly reimbursement reports based on approved claims and shares them with employers, who are responsible for executing payments based on their payroll schedule. - Reports are typically generated by Take Command on the last day of the month.Employers can access these reports in their admin portal under the 'Reimbursements' tab.
Key Documentation Requirements
Make sure your proof of coverage is compliant and current.
Regularly confirm the approval status of recurring premium claims in your member portal ahead of your employer’s report date.
Documentation must include your name, premium amount, current date within the last 30 days, and plan and provider details, including insurer’s name and logo.- If your plan effective date changes, submit updated documentation such as Proof of Coverage or an insurer bill reflecting the correct date to adjust your reimbursement timeline accurately.
How Reimbursement Allowances and Caps Work
Employer-Defined Allowances and Modifications
Your reimbursement allowance (e.g., $800/month) is determined by your employer. Employees cannot alter this amount independently. If you wish to request a change in your allowance, you will need to contact your employer directly, as they are solely authorized to make such changes.
Premium Costs vs. HRA Allowance Limits
If your insurance premium is lower than the monthly allowance set by your employer, you will only be reimbursed up to the premium amount. Unused allowance remains with the employer and cannot be utilized for other medical expenses unless specified under the employer’s plan. HRAs are not pre-funded accounts, so funds are only used for approved expenses. For example, if your premium totals $400 and your allowance is $300, you will still pay $400 to your provider but receive a $300 reimbursement.
Payroll Timing for Reimbursements
Reimbursement Cycle and Payment Delays
Delays can occur based on the timing of claims approvals and the employer’s payroll schedule:
Approved claims are added to a monthly reimbursement report sent to your employer, usually on the last day of the month.
Payments are then made by the employer, following their payroll timeline. If your claim is approved after the most recent report date, it will be included in the following month's report, potentially delaying your reimbursement.- Reimbursement reports are often generated on specific dates such as the 25th of the month. Claims approved after mid-month cutoffs (e.g., the 14th) will appear on the next month's report. - In some cases, reports may include multiple months’ reimbursements due to processing delays or overlapping cycles.- Payments made prior to the effective coverage date are ineligible for reimbursement. For example, if your effective date is delayed to August 1 and you paid in July, you will not be reimbursed for the July payment.
Understanding Reporting Types: Bi-Weekly vs. Monthly
While bi-weekly reporting may show reimbursements that exceed your monthly QSEHRA allowance, this does not mean you receive extra funds. The reporting format aggregates multiple claims but adheres to the employer-defined monthly cap. All reimbursements beyond the monthly cap remain ineligible and are not paid out.
Troubleshooting Reimbursement and Timing Issues
If you encounter discrepancies or delays in your reimbursements:
Check Documentation: Ensure your proof of coverage and claim approvals are up to date.
Verify Report Dates: Confirm that the employer’s report generation date allows sufficient time for approved claims to be included.
Adjust Scheduling: Employers facing missed reimbursements may benefit from settings such as designating the report date as the 2nd or the last day of the month to avoid processing omissions.
Contact Support: If manual report adjustments are needed, work with your employer or Take Command’s support team to resolve.- Verify Employer Access: Ensure that the employer has reviewed reimbursement statements under the 'Reimbursements' tab in their admin portal. - Delayed Payments: Understand that reimbursements approved after a given month's effective date will show up in the next month's report, e.g., July approvals appearing in August reports. - Address Mismatched Totals: If totals do not align with approved expenses, identify if some claims were approved after the cutoff date and thus deferred to the next month.
Correcting Taxable Reimbursement Classification: If a reimbursement is mistakenly labeled taxable, resubmit the original documentation with the correct coverage type and include a note explaining the correction for compliance team review.- Address Start Date Issues: If your insurance plan’s effective start date changes, only payments related to the coverage after the new start date are eligible for reimbursement. For example, if your effective date shifts from July to August, reimbursements will start from August.
Retroactive Coverage Limitations: Expenses incurred prior to the effective start date or gaps in coverage due to late applications cannot be reimbursed. Adjust your application timeline accordingly to avoid such gaps.
Revisions to Start Date Documentation: If your start date was wrong in your records, upload updated Proof of Coverage or purchase details with the accurate date. Once approved, reimbursements will reflect the updated start date.
By following the guidelines outlined above, employees and employers can effectively manage reimbursement processes, reduce potential issues, and ensure timely payroll integration for approved claims.
Frequently Asked Questions
Why am I paying the full premium even though I’m reimbursed partially?
With an HRA plan, you pay the full premium amount directly to your insurance provider. Afterward, Take Command reimburses you up to your approved monthly allowance. For instance, if your premium totals $400 and your allowance is $300, you will still pay $400 to your provider but receive a $300 reimbursement.
How do I correct a taxable reimbursement classification?
If a recurring reimbursement is mistakenly classified as taxable, resubmit the original documentation, ensuring you select the correct non-taxable coverage type. Include a note explaining the correction in your submission. The compliance team will review and update the classification to ensure future reimbursements are properly categorized.
Can I set up reimbursement for premiums exceeding my HRA allowance?
Yes, you can arrange for reimbursement even if your premium surpasses your HRA allowance. Submit documentation for the eligible amount (up to your allowance) through the Take Command portal. Any remaining balance must be paid directly to your insurer.
Pro Tips for Managing Your Reimbursements
Submit accurate, complete documentation: Ensure all required information is included in your uploads to minimize processing delays.
Monitor your submitted claims: Regularly check your Take Command portal to ensure claims are being processed correctly and on time.
Understand your HRA limits: Know your approved monthly allowance and plan your finances accordingly.