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Welcome CLA Family!
In 2020, CLA will be introducing a new wellness opportunity called BeniComp Select. This program will not be for everyone but may offer some nice tax advantages for members of the CLA family who:
- Aren’t able to participate in a FSA
- Have expenses that exceed the projected $2,750 FSA limit (BeniComp Select expenses can go up to $50,000)
- Don’t want to use their HSA dollars for their medical, dental or vision expenses.
This plan covers all of the same eligible medical expenses as a FSA/HSA and has an increased spending limit of $50,000 for the year. So if you anticipate having large medical expenses this year then BeniComp Select might be the best product for you. Below are examples of services people often run through their BeniComp Select policies:
- Braces ($6,000)
- Fertility ($25,000)
- Diabetes ($10,000/yr)
- Lasik surgery ($4000)
- Dental Implants ($2000 per tooth)
- Executive Physicals (3,000-10,000)
BeniComp Select also includes a $50,000 AD&D policy.
To calculate savings use the calculator below.
What do you need to know about this program:
- You will need to elect to participate in this program in Workday when you complete your open enrollment.
NOTE: You will not be electing a dollar limit that you expect to incur for 2020. Your election will indicate that you wish to participate in this program for the 2020 calendar year. - The cost to participate in this program is $250 per year plus an 12% administrative fee based on claims submitted to BeniComp.
- The $250 is non-refundable even if you do not submit any expenses for the calendar year, and will be deducted from your first paycheck in January.
To learn more about this unique new offering you will want to attend a webinar and visit the BeniComp page on myCLA which has examples of how the payroll reimbursement and deductions will work.
Benicomp Select Tax Calculator
Enter your estimated medical expenses and choose your tax bracket to calculate your savings!
When does it make sense to have BeniComp Select?
The simple chart below shows the estimated amount of annual medical expenses needed to save money with BeniComp Select. If your medical expenses are higher then you save more!
| Tax Bracket | Savings start after spending... |
|---|---|
| 22% | $1,456 |
| 24% | $1,219 |
| 32% | $695 |
| 35% | $584 |
| 37% | $526 |
Common denial reasons
Common Denial Reasons
- Any claims submitted with a cash register receipt.
- The supporting documentation must include the patients name, date of service and amount of service.
- Prescription denials
- Cash register receipts insufficient. Please submit the pharmacy receipt that is provided with the prescription (itemized receipt).
- Co-pays
- We cannot accept any credit card receipts for this. The supporting documentation must include the patients name, date of service and amount of service.
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Eligible Claims
What is covered?
A BeniComp Select policy reimburses eligible medical expenses not otherwise covered by health insurance.
Generally, if an expense is medically necessary and qualifies under Section 213(d) of the Internal Revenue Code, it would be eligible for reimbursement under this insurance plan. Some covered charges include, but are not limited to:
- Deductibles, co-pays, prescription drugs
- Private-duty nursing and home health care
- Hospital expenses, including private-room charges
- Dental and orthodontic expenses
- Alcoholism and drug-abuse treatment and facilities
- Vision care, including all types of frames
- Inpatient and outpatient psychiatric care
- Charges for the diagnosis of infertility
- Charges for the treatment of infertility
- Medical transportation, including air services and hotel
- Medical supplies and equipment
- This also includes the expenses of operating and maintaining a wheelchair
- Speech therapy for speech loss or impairment due to illness or surgery
- Pregnancy
- Smoking Cessation Programs
- Chiropractic services
- X-Rays
- Wigs purchased upon the advice of a physician for the mental health of a patient who has suffered hair loss due to a disease
- Acupuncture
- Prescribed Birth Control
- Lasik Surgery
- Contact Lenses
- Breast Pumps & Supplies
- Hearing Aids
- Vasectomy
What is not covered?
No benefits are payable unless the individual is under the direct care of a legally qualified physician for reasonable and necessary treatment.
- Any premiums including, but not limited to Base Plan (or Cobra Continuation of the Base Plan), Medicare Part B, Medicare Part D, Prescription Drug Plans
- Non-prescription drugs
- Expenses the individual is not legally obligated to pay in the absence of insurance
- Charges for appointments not kept
- Hospitalization, services, treatments or supplies furnished by the U.S. or foreign government agency, unless otherwise prohibited by law
- Service contracts or warranties relating to vision care
- Custodial care
- Accident or illness for which the individual is entitled to benefits under any worker’s compensation or occupational disease law
- Health club dues or exercise equipment
- Concierge doctor annual premium
- Blood Storage
- Hospital charges for confinement in a long-term care unit or skilled nursing facility unless confinement commences within 14 days after discharge from a qualifying hospital confinement
- Baby sitting, childcare, and/or nursing services for a healthy child. You cannot include any amount paid for childcare even if this enables you, your spouse, and/or dependent(s) to receive medical treatment.
