How Does the Reimbursement Process Work in Take Command?
Take Command provides a streamlined platform for managing Individual Coverage Health Reimbursement Arrangements (ICHRA). While Take Command does not directly handle reimbursements, it facilitates the process by tracking expenses, verifying eligibility, and generating reports for employers. Below is a detailed explanation of how the reimbursement process works for both employers and employees.
Overview of Reimbursement Operations
Take Command's Role: Take Command tracks submitted expenses, verifies their eligibility, and maintains notional ledgers for each employee. It generates monthly reimbursement reports that guide employers on how much to reimburse their employees. Most employers process claims through their payroll or checking accounts.
Employer's Role: Employers are responsible for reimbursing employees directly, using the reports provided by Take Command. Payment methods can include payroll, checks, or electronic transfers.
Employer Responsibilities
Reimbursement Reports: Employers receive monthly reports detailing the reimbursement amounts for each employee. These reports are available in the Admin Portal and can be downloaded as .csv or .pdf files.
Payment Methods: Employers can choose to reimburse employees through payroll systems, checks, or other methods.
Timing: Reimbursements are typically processed monthly, based on the reporting schedule chosen by the employer. For example, reports may be generated on the first day of each month.
Employee Responsibilities
Submitting Proof of Coverage: Employees must submit proof of their insurance premiums or eligible expenses to qualify for reimbursements. Acceptable documents include monthly bills or election of benefits documents. Acceptable documents also include an insurance ID card, premium invoice, and proof of payment, showing details such as the coverage start date, premium amount, plan name, and insurance company logo.
Recurring Expenses: Once proof of coverage is approved, employees can set up recurring expenses in the platform to automate monthly reimbursements. Employees must complete onboarding in the Take Command portal by selecting a health plan and uploading proof of coverage to set up recurring premium claims.- Non-Qualifying Plans: Memberships with local doctors are generally not recognized as qualifying health plans. Employees must select a qualifying plan and upload proof of coverage, including details like the premium amount, plan name, and insurance company logo.
Plan Eligibility: To qualify for ICHRA reimbursements, employees must select a health plan that meets eligibility criteria. For example, plans like the Silver 203 with Ambetter are eligible.
Reimbursement Timing and Processes
Approval and Reporting: If required documents are approved before the next reimbursement report is generated, employees will receive their reimbursement at the end of the current month.
Backdated Reimbursements: For delays in document approval, backdated reimbursements aggregate multiple months’ allowances into one payout.
Outstanding Amounts: Any portion of claims exceeding the employee’s allowance is marked as "outstanding" and is not reimbursed within that period.
Handling Employee Status Changes
Terminated Employees: Employees terminated during a month remain eligible for that month’s reimbursement. They retain portal access for 90 days post-termination to submit eligible expenses. After 90 days, they are moved to the "former" section and removed from reports.
Common Issues and Resolutions
Incorrect Reimbursement Amounts: If an employee’s reimbursement shows as $1, it may be due to an incorrect class assignment. Admins can update the employee’s class in the Admin Portal to resolve this.
Zero Reimbursements: A zero in the reimbursement report may indicate incomplete onboarding or missing documentation. Admins can review the report details to identify the issue. Employees who have not completed onboarding will not be included in the system for reimbursement tracking.
Processing Status: The status "Processing / Sending to Employer" means the reimbursement has been approved and sent to the employer for payment. No further action is required in the portal.
FAQs on Specific Scenarios
What does "reimbursement amount" mean?: It is the total dollar value your employer can reimburse for eligible expenses under your HRA plan.
How does the self-enroll model work?: Employees pay their premiums directly to the carrier, and employers reimburse the eligible amount based on monthly reports.
What does "outstanding reimbursements" mean?: It reflects approved claims exceeding the employee’s allowance, which are not reimbursed within the allowance period.
By understanding these processes and responsibilities, both employers and employees can effectively manage their reimbursement operations through Take Command.