IBEW LOCAL 191 HEALTH & WELFARE PERSONAL CARE ACCOUNT (PCA)
COMMONLY ASKED QUESTIONS AND ANSWERS
What is a Personal Care Account (PCA)?
The PCA was voted in by the IBEW Local 191 membership in June 2013
The PCA is sponsored by the IBEW Local 191 Health & Welfare Trust
The contributions are tax free and can be used to pay your eligible out-of-pocket medical or dental expenses that are not paid for by your insurance or any other benefit plan
The Plan must follow strict IRS guidelines
Are my dependents eligible for the PCA?
Yes. As long as your spouse and/or your dependents are enrolled in the IBEW Local 191 Health & Welfare Plan
How are deposits made to my PCA?
Deposits to your PCA Account are made by your employer and are not a payroll deduction
A contribution of $0.50 per hour is deposited into your account on the first week of every month
An example of your contributions are: Hours worked in October are paid by the employer in November and posted to your account the first week of December
When am I eligible to start using my PCA?
Once your account has reached $250.00
When you reach this amount, you will receive a Welcome Letter with additional information on the PCA account
Within 7-10 business days, you will receive a debit card that says “Benny”
Do I pay a monthly service fee for the PCA?
As of July 1, 2014, the IBEW Local 191 Health & Welfare Fund will pay the $5.50 fee per month
How do I use my “Benny Card” (debit card)?
You can use your “Benny Card” at the time of service with a provider or pharmacy
The card gives you immediate access to your current PCA balance
The card will only work for approved IRS expenses, i.e: prescriptions, co-pays, deductibles, etc.
Can I order a “Benny Card” with my spouse’s name and/or dependent?
No. The debit card company does not allow the card to be in anyone’s name except the member
Am I charged for replacement of my “Benny Card”?
Yes. The debit card company charges $10 for replacement
How long is my “Benny Card” valid?
The card is valid for three (3) years from the issue date
You will automatically receive a new card after three (3) years providing your account is still active
Can I only use my “Benny Card” to access the PCA?
No. If you do not use your card, you can submit the required documentation (listed below) for reimbursement
Do I need to submit any documentation for using my PCA or “Benny Card”?
Yes. The IRS requires specific documentation. Documentation includes:
Receipt from your provider, pharmacy or a copy of your Explanation of Benefits (EOB) from your insurance plan
Receipt or EOB must include name of the provider or pharmacy, patient name, member name if claim is for a spouse or dependent, actual date of service, cost of service and description of services provided (can also be CPT codes)
If you use your “Benny Card” at an IIAS approved merchant (typically a pharmacy), you will not need to provide further documentation
Why do I receive an email telling me I need to substantiate the use of my “Benny Card”?
The IRS requires that all reimbursement requests, whether by using the “Benny Card” or submitting a paper claim must include substantiation (with the exception of an IIAS approved merchant)
You will receive an email shortly after using your “Benny Card”
You will receive another email in seven (7) days
If we do not receive your substantiation, you will receive another email in twenty-eight (28) days
If substantiation is still not received, another email is sent at forty-five (45) days
At forty-six (46) days, your account is marked overdue
Ninety (90) days after using your “Benny Card”, your account will be de-activated until the substantiation is received
We understand that it does take a few weeks or more to receive an EOB from your insurance carrier, which is why we send multiple email reminders
Can I use my “Benny Card” to make my COBRA payment to IBEW Local 191 Health & Welfare Trust?
No. You will need to use a personal check to make your payment. You can then submit a copy of your COBRA invoice for reimbursement
How long will it take to get reimbursed when I submit paper claims?
BSI processes paper claim batches on Monday with paper checks mailed on Wednesday and then processes batches again on Wednesday with paper checks mailed on Friday
If you choose to have a paper check mailed, please allow 5-7 business days for receipt of your reimbursement check
You can set up automatic deposits to your checking or savings account. Funds are released on Monday and Wednesday for deposits into your account on Tuesday and Thursday
How much will I receive when I submit a claim?
You will receive the lesser of the amount you submitted or the balance in your account at the time of reimbursement
If your balance is less than the amount you submitted, the unreimbursed amount will automatically be reimbursed to you if another contribution of sufficient amount is made to your PCA Account
After I have incurred an eligible expense how long do I have to submit a claim for reimbursement?
You have twelve months from the date of service to submit your claim
When are expenses “incurred?”
IRS rules state that an expense is incurred at the time that the services are provided, not when an appointment is made, a bill is dated, or a bill is paid. The PCA can only reimburse you for eligible expenses that were incurred (provided/purchased) after becoming eligible for benefits
Can I request reimbursement of medical expenses and also deduct the same expenses on my income tax return?
No. The IRS states you can use the PCA Account or the itemized deduction, but not both for the same expense.
Can I access my balance and claim activity information on -line?
Once you are eligible, if BSI has your email address, you will automatically receive an email invitation from email@example.com
If we do not have your email address, once you receive your welcome letter, you can give us a call to and request an email invitation
Why can’t group health plans send the EOB for substantiation?
At this time, the health plan carriers are not able to electronically send EOBs directly to BSI
Although there have been discussions, it may be possible to revisit this in the distant future
What happens to my PCA Account if my employment ends?
You will be able to access your account balance even after your employment ends
The Trust Document states that if the account balance is more than $250, 36 months after the last account activity, your ending account balance will revert to the general Trust fund
The Trust Document states that if your account balance is less than $250, 12 months after the last account activity, your ending account balance will revert to the general Trust fund
Please Note: These questions and answers represent a brief summary of the Personal Care Account rules. They are not intended to provide legal or tax advice. If any statement in this document conflicts with the provisions of your formal plan document, the formal plan document will be considered to be correct.
Trust Office – 1.800.203.0544 or CDHP Dept. - 1.888.759.2664