To find out your employee's status, whether he or she has completed onboarding, has a compliant proof of coverage on file, or has submitted claims, log in your Member Portal.
First, in the Employee Roster, you can check your employee's QSEHRA or ICHRA status. It will show one of the following:
When an employee's status is "Active" it means that they have submitted proof of qualifying insurance and may begin to submit claims for reimbursement.
No Proof of Coverage
When an employee's status is "No Proof of Coverage," it means that either:
Their insurance plan does not meet the requirement to participate
We have asked your employee to submit additional information about their plan
Their proof of coverage is expired (we are past a compliance check date)
They have not yet logged in to complete onboarding.
When their coverage is expired or non-compliant, we will not allow employees to submit any medical expenses and disable all recurring expenses, so on your report you will not see any amount listed for them to be reimbursed.
This is specifically for those who are ineligible to participate in the HRA as an employee because of their ownership status.
This is for ICHRA employees who have waived coverage and are marked as non-billable.
This is for ICHRA employees whose ICHRA was unaffordable, so they opted out and received their tax credits instead.
To see whether your employee has submitted any claims you can check a few places.
First, you can run a Claims Summary Report. You can see all claims they have made, their status, and whether they have been reported to you on a reimbursement report yet.
You can also go back to the Employee Roster, click on the employee's name, and review the list of their claims. If there are none listed, they have not had any claims approved. In the list of approved claims, the "Reimbursed" column will show you how much of each claim has shown up on a monthly Reimbursement Statement. Here's what it means when it shows that $0 or only a portion of the claim has been reimbursed.
Before processing any reimbursements, you'll want to reference your Reimbursement Statements. These are statements we provide each month, or semi-monthly, or bi-weekly, in order to show you exactly how much to reimburse each employee.
After claims are reviewed & approved, we report the final numbers to you on a Reimbursement Statement so that you can reimburse your employees directly. This will help protect your employee's privacy and save you time in tracking their expenses.
Each reimbursement statement will show you what employees are owed based on allowances & claims applied since the last report ran. Click here for more info on Reimbursement Statements.
Still not sure where to start? Check out our Admin Resource Center for more resources and support.