rollover account usernames & passwords...phone: 1-800-291-5837 fax: 765-608-6691 step 4: after...

Muncie Community

Schools 2015 - 2016 Health Insurance, Important Dates, Claim Filing and More…

Online Tools

Unified Group Services provides online access to your

benefit plan information 24/7. The ActiveHealth

Personal Health Record (PHR) provides a way for you

to store your own personal health information in one

secure location through UnifiedGrp.com

MACTAVISH SCHOOL BENEFITS, INC. “We Fix Health Plans” SM

Rollover Account Usernames & Passwords

Write down your username and password for easy reference later

YourInsuranceCarrier www.UnifiedGrp.com Download electronic forms

Compare costs of various medical providers

Track medical claims

Monitor your account balances

File claims online

Username:____________________________________ Password:_____________________________________

AllunusedfundsfromyourHRASavingsAccount

(GreenBox)gotoyourRolloverAccountatthe

endofeachplanyear.YoucanspendyourRollover

dollarsonallincurredeligiblemedicalexpenses

(IRS213(d)includingbutnotlimitedto:braces,

eyeglasses,Lasik,oralsurgery,andmore.

HRA Savings Account

Rollover Account

www.WeFixHealthPlans.comReview Educational Videos

Username:MuncieSchools Password:munciebene its

MACTAVISH SCHOOL BENEFITS, INC.

“We Fix Health Plans” SM

Step 2: Out-of-Pocket

Single Plan

EE +1 & Family Plan

Step 1: HRA

Step 3: Muncie 105

Account

Important Dates

December 31st

Lastdaytosubmitmedicalclaimsforthecalendaryear.ClaimssubmittedafterDecember31willbeappliedtotheHRAAccountand/ordeductibleprovisionsinthenewcalendaryear.

AllunusedHRAaccountdollarsfromthecurrentyearbecomeRolloverdollarsaccessedbytheplanparticipantforunreimbursedexpenseseligibleunderIRSrules&regulations.

January 1st

HRAAccountrenews 105Accountrenews Medicaldeductiblestartsover

Contact Us Mactavish School Benefits, Inc. 7825 Washington Ave S, Suite 500 Bloomington, MN 55439 Phone: (952) 942-6838 Fax: (952) 942-6843 fax info@wefixhealthplans.com

www.wefixhealthplans.com

How to File a Medical Claim

How it works... StepOne:The irst$1,000/$2,000(singleplan/EE+1orfamilyplan)ofeligibleexpensesarepaidfromyour2015HRAAccount.MarktheappropriateboxontheExplanationofBene its(EOB)document.(EE+1&FamilyisequaltohavingtwoSingleplans.)StepTwo:Thenext$1,000/$2,000isyourout‐of‐pocketexpense.IFYOUHAVEHRA/ROLLOVERDOLLARS,youcanaccessthatmoneytocoversomeorallofyourout‐of‐pocketexpenses,dependingonyourrolloverbalance.StepThree:Thenext$3,000/$6,000ofexpensesarepaidat100%outofthe105account.ThisispartofyourdeductiblebutDOESNOTcomeoutofyourpocket.HOWEVER,youwillstillreceiveanEOBandmustmarktheboxforthe105account.StepFour:Medicalexpensesabove$5,000/$10,000arenolongerpartofthedeductibleandyouwillnotberequiredtomarkanycategoryfortheprovidertobepaid.

1. FilloutatheupperrighthandboxonyourEOB2. Mail,faxoremailcompletedformtoUnited

GroupServicesQuestions?ContactLindy,yourdedicatedUni iedClaimsAccountManagerat1‐800‐291‐5837

Electronic 1. Gotowww.Uni iedGrp.com2. Click“LogintoUni iedGroupServices”3. Click“HRAClaimForm”4. InformationisAuto‐Populated5. Click“Submit”

Mail or Fax

Unified Group Services, Inc. PO Box 10

Pendleton, IN 46064 Phone: 1-800-291-5837

Fax: 765-608-6691

Step 4: After Deductible

Insurance Plan

Pays 100% of claims

**Assumes In-Network

$1,000

Unlimited

$3,000

$1,000

Unlimited

$6,000

$2,000

Personal Health Reimbursement Arrangement Illustration

100% Coverage for Routine Physical, Routine Eye Exam, Cancer Screening, Pap Smear, Mammogram, Prenatal, Well

Baby Care and Immunizations.

Rx: $5 Generic 25% Preferred Brand

35% Non-Preferred Brand Single Coverage: $1,350 Rx Maximum Family Coverage: $2,700 Rx Maximum

$2,000