Questions and Answers
You have questions; we have answers. Below are commonly asked questions below to help clarify who we are, what we do, and how we do it.
What is AleraEdge?
-Suite of administrative services designed to strengthen and complement your benefits solution.
Call center support and hours?
-8:00am – 4:30pm EST
What services are provided thru AleraEdge?
-COBRA and Retiree enrollment and management
-WorkSmart Solution Benefit Administration
-Carrier bill adjudication
-Carrier enrollment and termination
-ACA-tracking and reporting
What access do I have to reports?
-FUNDING REPORTS – bank activity reports (ACH)
Employer Funding Notification – Weekly funding report for claims paid (including mobile app, portal, email, fax). This report is posted by Monday afternoon and an email goes to all client contacts with approved access to reports. This Excel document provides a summary on sheet one, and detail on sheet 2 of the claims being funded. The total shown represents the amount that will be debited from your bank account Wednesday night and is listed as AleraPay.
Debit Card Funding Report - Weekly debit card report for settled swipes. This Excel report is posted by Monday afternoon and an email goes to all client contacts with approved access. The report provides a total on sheet one, and details on sheet two, of the swipes being funded. The ACH transaction that will debit this amount from your bank account will occur on Tuesday and is listed as Bancorp.
Account Balance Detail Report – Posted weekly and available ad-hoc, provides detailed employee account information, such as elections, rollovers, approved and denied claim totals, and plan balances.
Pending Repayments Report - Posted weekly, provides a list of participants that have used their AleraPay card for an ineligible expense that must be repaid to the plan.
Enrollment Report - Posted weekly, provides a comprehensive plan participant list.
How do I check my balance?
-Log into your AleraPay Participation portal
-Click Participant Login on the right-hand side of the page.
-Enter your user name and password
-If you are a first-time user enter your default login information — first initial, last name, date of birth "DDMMYY" (no spaces). If your default login is not working, make sure you are entering the date of birth as shown above.
-Your first-time password is last name and last four digits of SSN# (no spaces)
-Balance information will be displayed on the left-hand side of the page.
Why am I getting a substantiation request (1streceipt, 2nd receipt, or Request for more information - RMI)?
-AleraPay administers your tax-sheltered reimbursement accounts and is required, by the IRS, to show the plan has been properly administered. For you, this means that you will be required to provide an itemized receipt and/or EOB for some or all your transactions. This information contains protected health information and is not transmitted in your debit card transactions, and AleraPay can't request it on your behalf. This process is designed to protect you, your employer as the plan sponsor, and AleraPay as the plan administrator.
What do I need to send in to satisfy a substantiation request?
-An EOB (Explanation of Benefits)
-This is a document created by your insurance carrier/company. It is most identifiable by stating “THIS IS NOT A BILL” at the top in bold letters.
-These notices may be mailed directly to you, but you can always call to request a copy or go to your insurance carrier’s website to access your claim history. Check your insurance card for contact information.
-An itemized/5 item receipt.
-This is a detailed receipt that you can obtain from your provider directly. It will need to show the following 5 pieces of information;
- Provider name
- Patient name
- Date of service
- Description of services rendered
- The amount owed/paid after any/all applicable insurance payments
** Please note that even with itemized receipt an EOB may be required for certain account types. **
How do I submit documentation?
You can submit the requested information by any of these means.
-Using the mobile app click file a claim and follow the prompts, upload receipt and submit claim take a picture of receipt/EOB and follow prompts
-While logged into the participant portal attach the receipt/EOB
-Fax receipt/EOB AND claim form to 585-641-7500
-Mail receipt/EOB AND claim form to AleraPay, 400 WillowBrook Office Park, Ste 400, Fairport, NY 14450
How do I file a claim through the portal?
-From the home page, click File a Claim
-Fill out prompts and click Next
-Upload valid documentation and click Next
-Fill out claim details and hit Next
-Confirm details and submit the claim
** NOTE: You will be required to upload a document to file the claim electronically **
How do I check the status of my claim?
-From the Home page locate the Dashboard tab
-Locate your claim (listed in the date of service order)
-Click on the claim line to see additional claim details
How do I update my personal information?
-Please contact the AleraPay team directly to update your profile information: 800-622-6233
Frequently asked debit card declined questions
-My card has not been activated
Call the number on the card to activate
-My card has no funds remaining card has insufficient funds and the merchant does not support partial authorization
Check your account balance through the mobile app or online portal
-My card has sufficient funds, but the merchant does not support partial authorization
Call customer service at 1-800-622-6233
-I am attempting to purchase only non-healthcare eligible items with a card that has only an FSA and/or HRA purse
Your plan is limited to certain purchases, refer to your plan documents for debit card details
-My card is expired, how do I get a new one?
Go online and order a card, PROFILE tab then BANKING/CARDS
Or call customer service at 1-800-622-6233
Do I have access to participants and their information?
-Yes, you can access through the employer portal a participant plan elections, payments, and communications.
Will I be able to determine who owes and who doesn’t?
-Yes, the remittance report or paid through report can be pulled to tell you this information.
Do you pay the carrier for me?
-No, we currently do not have this functionality set up.
When do you send me the collected premium?
-Once the month has closed, premiums are sent the second Tuesday of the following month.
Does the participant have access to process elections and payments online?
-Yes, the participant has access to a website and a mobile app.
What ways can our employees pay their premiums?
-ACH out of banking accounts, by check/money order, or online/mobile app with a convenience fee.
How do I pay my premiums?
-You may pay via ACH out of banking accounts, by check/money order, or online/mobile app with a convenience fee.
Will I be able to see that my payments have posted?
-Yes, you have access to the website and mobile app.
Will you let me know what I owe for each month?
-Yes, coupon booklets will be sent upon the initial election.
How does the process get started?
-Scheduling a call with the WorkSmart Solution team to discuss client needs, the WorkSmart Solution processes, and schedule a demo.
How will the cost be determined?
-The pricing is established based on the system that best fits the client’s needs and the number of benefit eligible lives.
When is the best time to start onboarding?
-It is best practice to onboard new technology well in advance of open enrollment, so clients and their employees have ample time to get acquainted with the new system before going through open enrollment. Onboarding should begin six to eight months before open enrollment typically occurs.
How will the onboarding process work?
-Onboarding consists of four main phases: Overview & Discovery, Kickoff, Build & Testing, and Go Live.
How long is the onboarding process?
-The onboarding process is six to eight weeks.
Who should be involved in the onboarding process?
-The client and Alera partner should be involved in the process.
Will training be a part of the onboarding process?
-Yes! WorkSmart Solution will provide training on the system and how to use it. WorkSmart Solution will be available throughout the year to answer questions and provide additional training.
How does the process get started?
-Fill out the Scope of Work (SOW) form and email it to the ACA Reporting East team at firstname.lastname@example.org
How will the cost be determined?
-The pricing tier is established by the estimated number of 1095’s provided on the SOW. It is generally a good practice to use last year’s number and account for any major changes to populations.
What information would need to be provided?
-The SOW, signed service agreement, a gatekeeper and filing contacts, and the completed data workbook.
What’s a gatekeeper and do I have to assign one?
-Yes, a gatekeeper is the person in charge making sure the process is flowing smoothly with all parties involved. This will help ensure the most pleasant experience for all parties. There will be a gatekeeper assigned on the ACA team’s end as well.
When should data be provided?
-Data can be provided starting in December and should be sent as soon as it is gathered in order to provide the most time possible for auditing.
How long does the process take once all of the required information is provided?
-2 to 3 days.
Will the client be able to review the 1095C forms before they are submitted?
-Yes, the filing contact and or gatekeeper will be required to review prior to filing.
Will the client be notified if the IRS does not accept the filing?
-Yes, a filing status will be sent out to both the filing contact and the gatekeeper.
Will the client receive copies?
-Yes, the 1094C, 1095C and Error report will be provided after the filing is complete.
Does the invoice have to be paid by ACH?
-No, but there will be a $25 fee for not paying with ACH.
What if there are corrections after the filing is complete?
-Any corrections will be processed accordingly, and any additional form charges invoiced appropriately.
What type of Form 5500 filings may be completed by the Alera Form 5500 Center of Excellence (COE)?
-COE can prepare health and welfare plan filings for first-year, amended and delinquent Form 5500 filings. COE does NOT prepare filings for funded welfare plans (when benefits are paid from a trust or a financial account other than the plan sponsor’s general assets) or pension plan filings.
What is the cost to complete the Form 5500 and accompanying Schedules?
-The Alera firm offering this service will review pricing with you.
As the Plan sponsor, what are my responsibilities with regard to Alera Form 5500 Services?
-Under the Alera Form 5500 service model, plan sponsors are required to:
-Sign the service agreement
-Work with your Alera firm as needed to complete the data collection form (DCF), which is the form the COE uses to gather and understand the information needed to properly prepare your Form 5500.
-Work with your Alera firm as needed to collect the Schedules A for the fully insured benefits under the plan.
-Once the filing is complete, review the filing.
-Have the plan sponsor/administrator sign the filing with EFAST2 filing credentials (obtained by the DOL). Instructions on how to obtain DOL credentials may be provided.
-Once the summary annual report (SAR) is provided, distribute the SAR to participants as required. (Complete distribution instructions will be provided when SAR is provided).
What is the timeline for the COE to prepare the filing?
-The COE will start the process to gather the data needed for the Form 5500 filing 4 months before the month of the filing’s normal due date. For example, if a filing is due July 31st, the COE will start the process to complete the filing around April 1st. If information is not received by the COE, periodic reminders will be sent at 3 months and 2 months prior to the form’s due date. If all required information is not received by the COE 1 month prior to the due date, an extension, Form 5558 will be completed and submitted by the COE (A copy of the submitted Form 5558 will be provided to plan sponsor.) Form 5558 extension filed by request or due to non-receipt of data will incur a fee of $75. The COE will complete and timely mail the Form 5558 via an approved mailing method with the shipping confirmation.
How does the COE complete the 5500?
-COE has experienced Form 5500 preparers familiar with Form 5500, accompany Schedules and filing requirements. The COE will complete the Form 5500 filing based solely on the data provided in the DCF form and Schedules provided. The COE uses DOL approved web-based software to prepare the filing. The software runs a strict validation audit to mitigate the risk of unaccepted filings.
How will the Form 5500 prepared by COE be accessed?
-The COE uses a web-based portal to complete the filing since DOL rules require that filings are submitted electronically through DOL approved the software. The portal allows the plan sponsor and referring Alera firm to review the filing. Once the filing is complete by the COE, the plan sponsor and referring Alera firm will receive an email notification that includes a link to the portal and login instructions. Forms and Schedules may be printed in the portal if the reviewer prefers a paper copy to review. Note that paper copies of the Form are no longer accepted, and filings must be submitted electronically.
What if changes are required to the Form 5500 before it is submitted to the DOL?
-If changes are required on the filing, please notify the COE or your referring Alera firm.
How is the Form 5500 filing signed?
-The individual authorized to sign as the plan sponsor/administration should have DOL filing credentials. The credentials include a User ID (assigned by the DOL) and 4-digit PIN (chosen by the signer). These credentials are required to sign the filing. Individuals may apply for credentials at efast.dol.gov. If the signer has received filing credentials in the past, the same signing credentials may be used year after year. Individuals my go through the DOL process to retrieve a forgotten login ID and/or password.
How will I know if the DOL accepts the filing?
-The COE will notify the plan sponsor (employer) and the referring Alera firm through email once the DOL accepts the filing.
When and how will the Summary Annual Report (SAR) be distributed?
-The SAR will be prepared within 2 weeks of the DOL’s acceptance of the filing and emailed to the Form’s signer with instructions for distribution. The referring Alera firm’s gatekeeper will be copied on the email.
When is a payment due?
-Once the DOL has accepted the filing, and the COE has prepared the SAR, the COE will prepare an invoice for the plan sponsor that will be sent directly to the plan sponsor (unless the Alera firm will be paying for the services.) The preferred method of payment is ACH withdrawal. The ACH form will be provided with the service agreement. Payment submitted via paper checks will incur an additional $25 fee.
Can the COE assist with delinquent or amended filings?
-The COE can assist with amended or delinquent filings. Reach out to your employee benefits advisor for more assistance with this.
Who can I contact with questions?
-Questions should be sent to the COE mailbox: email@example.com. The COE will work to route your email to a member of our team who will contact you.