This section outlines 13 features to look for with HRP Administration Software.
Employers should be able to give employees allowances with automatic monitoring of HIPAA and ERISA discrimination compliance rules. Deferred allowances should be possible for new hires, and suspended HRPs should be allowed for former employees that employers hope to re-hire on a seasonal basis.
Employees should be able to submit reimbursement requests online, via fax, or mail, and immediately receive an email acknowledging their claim and providing an online link to monitor claim status. Premium documentation should be permanently available online for the convenience of employees desiring such access to copies of invoices, etc.
Reimbursement requests should be processed within 24 hours and employees should be able to inquire about their claim via online chat, email, fax, mail or telephone. No request should be rejected for improper submission without multiple contacts from their Plan Supervisor. All employee contact should leave clear audit trails and meet appropriate regulatory guidelines (e.g. IRS, HIPAA, ERISA, SAS 70).
Employees should receive email notification when their reimbursement request is approved and again confirming when (and how) it is reimbursed. Reimbursement should be administered individually or on a batch periodic basis via check, payroll addition, or direct deposit leaving a clear and permanently-available audit trail.
All employees should have access to an online ledger showing their current HRP balance, allowances, claims, and reimbursements including permanent storage of receipts, relevant tax information, and the ability to save or export their own medical information via the administration platform.
The HRP Plan Document and HRP SPD (Summary Plan Description) should be electronically created, readily accessible online, and signatures should be collected electronically. Employers should be able to administer a change to benefits for any specific Class of Employees at any time and the electronic documents should automatically change and, where required, new electronic signatures should be collected when the employee is next online.
Employers should be able to instantly create online unlimited different Classes of Employees with each Class receiving different benefits by employee family status.
Employers should be able to instantly enroll or remove employees in real-time on an individual or batch basis, with automatic printing of employee Welcome Kits and other appropriate plan administration information.
Employers should be able to completely set up and/or change both their HRP plan and their Plan Documents simultaneously online.
Employers should be able to view all reimbursements by employee or by Class of Employees, and monitor in real-time de-identified Claim information for each Class of Employees by Category of Expense. Employees should be able to see 3-5 prior years of HRP expenses broken down by categories of expense.
All information for required administration reporting (e.g. 5500 for employers with more than 100 employees) should be available online in real time, and non-eligible HRP participants (e.g. independent contractors, owners of Sub S companies) should receive appropriate 1099 information.
The Software should have helpful resources for employees on personal health insurance. Additionally, look for Software that automatically provide their health insurer(s) a CRM (Customer Relationship Manager) to best serve their employees—including automatic notification to insurer(s) when an employee’s plan status changes due to family additions, promotions, etc.
The Employer should be automatically protected and the HRP administration made HIPAA Compliant through technology rather than the training of administering employees. For example, employers should not be able to view HIPAA-protected employee information, and should automatically follow Department of Labor HIPAA and ERISA guidelines for employers allowing insurers access to their employees.