Take Charge with SHPS Member Website

SHPS maintains a website where employees can access their flexible spending account information at any time. It is SHPS' standard process to rely on members to check the statements posted on the website for the status of their claims.

Account Statements

For employees who have provided an email address, SHPS sends emails with a link to the member portal whenever new statements were posted. After log-on, employees can see an overview of their spending account information, but the more important detailed information on the status of claims is included in the "Statements" section to the right. If SHPS does not have an email address on file, employees will receive a quarterly paper statement. A schedule of Statement mail dates for 2008 is in the chart below.

Validation Return Forms 

The IRS requires that every single transaction paid by the spending account card be validated as a qualifying health care expense. This means that SHPS must gather proof of some sort to document every purchase. The IRS allows certain transactions to be validated electronically—these include charges that match plan-specific co-pay amounts and co-insurance amounts (as documented electronically) as well as over-the-counter transactions from vendors who have established data sharing systems to meet IRS requirements. As the technology supporting these programs continues to advance, you can expect more electronic validation, but at this point, much of the validation must still occur via paper receipts. 

UC provides a file of co-pay amounts to SHPS and they use this to validate co-pays. Per IRS rules, the co-pay must match the card transaction exactly or it will not be validated. For co-insurance plans, VSP and Delta Dental provide monthly files that identify specific member's co-insurance amounts. Currently, these are the only two plans sharing co-insurance amounts with SHPS. These co-insurance amounts must match exactly or the transaction will not be validated electronically. 

For those transactions which are not able to be validated electronically, SHPS must receive a paper copy of the receipt. This is an IRS requirement. There is a delay in SHPS asking for the receipts because they attempt to validate electronically during the first 2-3 months following the payment. If they are not able to validate electronically, then they mark the claim as "Potentially Ineligible" and request a paper receipt.

Employees with spending card transactions in the "Potentially Ineligible" category will receive a validation return form along with the statement. The statement includes a note indicating "Action Required" in addition to the heading of "Potentially Ineligible Expenses." This calls an employee's attention to the fact that they are required to act on these items.

60 Days to Send Receipts to SHPS

Any required validation receipts are due in 60 days. If the required receipts are not received in 60 days, the claim will be identified as "ineligible," however SHPS will continue to accept and process receipts for transactions beyond the due date. For employees who have provided their email address, SHPS will send an email acknowledgement which documents receipt of a Validation Return form and its accompanying documents.

Once the form and documentation is reviewed and processed by SHPS, the results of the processing will be conveyed to the employee when the subsequent statement is generated in one of two ways:

• If the transaction is approved, it will no longer be listed on the statement as a potentially ineligible or ineligible item. It will be removed.
• If the transaction is denied, the transaction will still appear on the statement (in the ineligible a category) with a brief explanation as to why it was denied.

What If?

In the event the card was used for ineligible expenses or the employee is unable to find the receipt to validate the purchase, employees have a couple of options:

• Send a check to SHPS to reimburse the ineligible expense.  
• Send another receipt for an expense equal to (or greater than) the overpayment in order to offset the amount overpaid by SHPS.

Deadlines

Employees enrolled in HCRA and/or DepCare only have until March 15, 2008 to spend unused funds from their 2007 account. Employees have until June 15, 2008, to file claims for expenses paid with 2007 funds.

Save All Receipts

Employees must retain receipts for all spending account card purchases. SHPS may ask for a copy of the receipt if needed to validate the purchase as an eligible expense.

Statement Mail Dates for 2008

Below is a schedule for statements to UC participants for the remainder of the year.

Campus Human Resources, Benefits Services
Phone: (310) 794-0830 | Fax: (310) 794-0835