Discovery Benefits, Inc.

Discovery Benefits is a third party administrator that provides reimbursement account administrative services on behalf of employers pursuant to service contracts with the employer. Discovery Benefits does not sell directly to individuals and does not have individual service agreements with...

employees or participants.   IRS rules govern substantiation requirements for the health FSA, including expenses paid using the debit card.  Included below are excerpts from the IRS regulations governing substantiation requirements.   1.125-6(b)(2) All claims must be substantiated. As a precondition of payment or reimbursement of expenses for qualified benefits, a cafeteria plan must require substantiation in accordance with this section. Substantiating only a percentage of claims, or substantiating only claims above a certain dollar amount, fails to comply with the substantiation requirements in §1.125-1 and this section.   1.125-6(3)(i) In general. All expenses must be substantiated by information from a third-party that is independent of the employee and the employee’s spouse and dependents. The independent third-party must provide information describing the service or product, the date of the service or sale, and the amount. Self-substantiation or self-certification of an expense by an employee does not satisfy the substantiation requirements of this paragraph.   Due to the amount of personal information required for a complete response, Discovery Benefits will send a letter directly to the participant and not respond through the Revdex.com.

The plan in which this participant is enrolled is an employer-sponsored plan governed by IRS regulations and plan rules as defined in the employer’s plan document and summary plan description.  Discovery Benefits provides administrative services on behalf of employers pursuant to service...

contracts with the employer.  IRS rules governing substantiation requirements for the flexible spending accounts require that all claims must be substantiated, even those paid using the debit card. Substantiation documentation must provide information describing the service or product, the date of the service or sale and the amount. See 1.125-6(b)(2) and 1.125-6(3)(i).  Credit card or payment receipts do not normally meet the substantiation requirement as they do not include the date or type of service incurred.Notices have been sent to the participant advising her what information is missing.  The participant will want to submit documentation containing the additional information, as well as the other information required by the IRS.  It is important to note that documentation is processed at face value, meaning only documentation received with the request is reviewed.  Due to the volume of documentation received, we cannot review documentation sent to us previously to determine if it could be combined.  The participant needs to submit all required documentation at the same time.If the participant has any questions about what is needed, we recommend she contact Discovery Benefits so we can help answer her questions.

The plan in which this participant is enrolled is an employer-sponsored plan governed by IRS regulations and plan rules as defined in the employer’s plan document and summary plan description.  Discovery Benefits provides administrative services on behalf of employers pursuant to service...

contracts with the employer.  According to the terms of the plan under which this participant was enrolled, terminated employees are allowed to submit claims within 90 days after termination for expenses incurred prior to the termination date.   This information was included in the Summary Plan Description provided to all eligible employees upon enrollment by the participant’s former employer.  In addition, the information shown below was available to the participant through the online consumer portal.  The Final Service Date is the last date for the participant to incur claims. For this participant the final service date was July 28, 2017. The Final Filing Date is the last date to submit those claims in order to receive reimbursement. For this participant the final filing date was October 26, 2017.  Because the final filing date has passed, additional claims cannot be accepted. Any funds that may remain in a participant’s account after the end of the plan year are forfeited to the employer-sponsored plan and are not retained by Discovery Benefits.

The plan in which this participant is enrolled is an employer-sponsored plan governed by IRS regulations and plan rules as defined in the employer’s plan document and summary plan description. The participant used his debit card to pay for services on March 14, 2018. The financial institution...

that supports the Discovery Benefits debit card uses a pre-authorization status that may last between seven and ten business days. Discovery Benefits does not have authorization to release the funds. As the pre-authorized funds have now been released, the 2017 plan year has been credited.Because the 2017 account was credited once the pre-authorized funds were released, Discovery Benefits was able to move the claim filed for reimbursement on March 15, 2018 from the 2018 plan year into the 2017 plan year. The 2018 funds are now available to be used for eligible 2018 services.

Initial Business Response /* (1000, 5, 2016/03/04) */
Discovery Benefits is a third party administrator that provides pre-tax reimbursement account administrative services on behalf of employers pursuant to service contracts with the employer. Discovery Benefits does not sell directly to...

individuals and does not have individual service agreements with employees or participants.
Discovery Benefits received a call from the participant's spouse on January 6, 2016. As she is not an authorized representative for the account, Discovery Benefits could only provide general information. She had questions about a debit card being declined at the merchant. The claim was denied due to the merchant code not being a code used by medical or dependent care networks. The participant's spouse was also provided with information on how she could be designated as an authorized representative for the account and how to complete the necessary Dependent Care Form.
Discovery Benefits received a call from the participant on February 9, 2016. The participant was assisted with logging into the participant portal and locating the Dependent Care form.
The participant contacted Discovery Benefits again on February 25, 2016 and requested confirmation that he was completing the form correctly.
Discovery Benefits received a completed Dependent Care form on Thursday, February 25, 2016. A claim was processed on Monday, February 29, 2016, within Discovery Benefits' two-business day turnaround time. The first reimbursement was sent on March 1, 2016.
Under IRS regulations, reimbursement from the Dependent Care Account can only be made up to the balance in the account at the time the request is made. Any remaining amount will be reimbursed as contributions are made to the account.
Initial Consumer Rebuttal /* (3000, 7, 2016/03/05) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Discovery Benefits provided INCORRECT information to my spouse AND provided the documents, which were the INCORRECT documents for reimbursement. My husband can not wait over an hour to speak with any representative, as he needs to WORK. Discovery Benefits does NOT answer calls in a reasonable manner, which makes something such as a reimbursement, almost impossible to do. If it takes 30 minutes to answer your phone calls, shouldn't the cs representatives give accurate information, in the most apologetic fashion, and NOT be argumentative? ??? My husband and I have contacted Discovery benefits before the card was charged, to be sure it would go through. Then we contacted them AGAIN once it was declined. Then my husband contacted them again AND had to resend the copy of the receipt, not once but TWICE. Then he called to make sure it was received. Only to be told it was THE WRONG FORM AND HE WOULD HAVE TO RESEND ANOTHER FORM!!! Each time he calls or I call, it takes well over 30 minutes just to answer the phone! We have better things to do than wait for this company to handle the call volume that they clearly CAN NOT handle! Only since I have escalated this to the Revdex.com had discovery benefits claimed to mail out our check. This company clearly does NOT wish to reimburse any of its customers and makes you jump through hoops. We should not have waited until March for a reimbursement that we were told only takes 2 days!!! Our reimbursement has been sitting for weeks!! We had a supervisor say that they would escalate the process of our reimbursement since THEY failed to send my husband the correct form for my sons day care expense. We had to keep calling and calling UNTIL this was escalated. Still no reimbursement check. Discovery Benefits is NOT providing customer service or ANY type of service in timely manner. They probably do this, hoping that the experience will sour ANYONE from pursuing reimbursements.

I am rejecting this response because: It does not address the problem that I have not received the information they claim I did and cannot show that I did. Further, the IRS does not mandate their October cut off date. There is no concern for me, a customer, not receiving the information that are holding against me. Additionally they had ample opportunity to notify me before the final file date, as demonstrated by the letter sent to me after the date had passed related to a claim.Their contact with me after their arbitrary final file date should be grounds to allow me to file claims against the money in my account. It is not unreasonable to expect any communication from them to include a final file date if they can also put it in an obscure corner of the online profile and send letters after it's passed.

Discovery Benefits is a third party administrator that provides COBRA administrative services on behalf of employers pursuant to service contracts with the employer. Discovery Benefits does not sell directly to individuals and does not have individual service agreements with employees, participants...

or qualified beneficiaries.   Discovery Benefits is not an insurance carrier and does not have access to or control of the records or processes of insurance carriers.   Due to the amount of personal information required for a complete response, Discovery Benefits will send a letter directly to the participant and not respond through the Revdex.com.

Initial Business Response /* (1000, 5, 2016/03/01) */
Discovery Benefits is a third party administrator that provides COBRA administrative services on behalf of employers pursuant to service contracts with the employer. Discovery Benefits does not sell directly to individuals and does not have...

individual service agreements with employees, participants or qualified beneficiaries. Discovery Benefits is not an insurance carrier and does not have access to or control of the records or processes of insurance carriers.
According to its standard process, Discovery Benefits notified the carrier on September 21, 2015 of this participant's reinstatement of coverage effective October 1, 2015 following the receipt of her complete enrollment.
Discovery Benefits was contacted by a representative from the insurance carrier for this participant on November 13, 2015. The representative requested Discovery Benefits resend the reinstatement request and provided an email address. Discovery Benefits sent the reinstatement request to the email address provided the same day.
The participant contacted Discovery Benefits on November 18, 2015 and advised that her coverage was not active with the carrier. Discovery Benefits emailed the reinstatement request to the carrier again on November 18, 2015 and received confirmation from the carrier that the coverage had been reinstated.
Due to a plan coding change provided to Discovery Benefits by the participant's former employer, the plan under which this participant is enrolled was terminated and reactivated on December 20, 2015. Discovery Benefits notified the carrier of the addition of the plan with the "new" code effective January 1, 2016 on December 21, 2015. Discovery Benefits also notified the carrier of the termination of the plan with the "old" code effective December 31, 2015 on January 11, 2016.
Discovery Benefits received a call from the carrier on February 4, 2016. The carrier requested the notification be resent. Discovery Benefits resent the notification the same day and received confirmation of the update from the carrier on February 8, 2016.
Discovery Benefits was notified by the carrier and the participant on February 24, 2016 the coverage was again terminated. Discovery Benefits sent an urgent update to reinstate coverage on February 24, 2016 and received confirmation on March 1, 2016 of the reinstatement of benefits.
It was later determined that on February 11, 2016, a duplicate of the January 11, 2016 termination notification for the plan with the "old" code was inadvertently resent to the carrier. Updates have been made to ensure this is not an ongoing issue and we apologize for the concern this caused the participant.
Initial Consumer Rebuttal /* (2000, 7, 2016/03/02) */
(The consumer indicated he/she ACCEPTED the response from the business.)
This company erroneously canceled my insurance three times. It took me well over three hours of phone calls to eventually straighten this mess out. The last two cancellations were only corrected with the help of Blue Cross agents, as Discovery gave me the runaround on almost every call.
I didn't expect more than an apology from them, but I DO expect continuity of service in the future as promised in their response

Discovery Benefits is a third party administrator that provides COBRA administrative services on behalf of employers pursuant to service contracts with the employer. Discovery Benefits does not sell directly to individuals and does not have individual service agreements with employees,...

participants or qualified beneficiaries.  Discovery Benefits is not an insurance carrier and does not have access to or control of the records or processes of insurance carriers.  Due to the amount of personal information required for a complete response, Discovery Benefits will send a letter directly to the participant and not respond through the Revdex.com.

Discovery Benefits is a third party administrator that provides COBRA administrative services on behalf of employers pursuant to service contracts with the employer. Discovery Benefits does not sell directly to individuals and does not have individual service agreements with employees,...

participants or qualified beneficiaries.  Discovery Benefits is not an insurance carrier and does not have access to or control of the records or processes of insurance carriers.  Discovery Benefits’ system continues to show the participant as active on continuation coverage and there is no record of Discovery Benefits sending a termination notice to the carriers for this participant.   In addition to sending the reinstatement notice to the carriers on June 5, 2017, Discovery Benefits has reached out to the carriers regarding this participant three times since August 30, 2017 and continues to work with the carriers to obtain confirmation of coverage.  Discovery Benefits will send a letter directly to the participant with additional detail.

In order to protect the individual's privacy and allow us to include full detail in our response, the individual will receive a letter directly from Discovery Benefits.

Discovery Benefits is a third party administrator that provides pre-tax reimbursement account administrative services on behalf of employers pursuant to service contracts with the employer. Discovery Benefits does not sell directly to individuals and does not have individual service agreements with...

employees or participants.
Due to the amount of personal information required to provide a complete response to the participant, Discovery Benefits will send a letter directly to the participant.

Discovery Benefits is a third party administrator that provides reimbursement account administrative services on behalf of employers pursuant to service contracts with the employer. During this time of year when a large number of employers’ plan years come to a close, our call volumes and wait...

times may increase at any given time during the day. We place the utmost importance on customer service and strive to respond to calls and emails from participants as quickly as possible and keep the call wait times as short as possible. Discovery Benefits provides a chat option in addition to email.The participant was enrolled in a flexible spending account (FSA) for the 2017 plan year and is not enrolled in an account for the 2018 plan year. The final service date for the 2017 plan year was December 31, 2017. As a result, the debit card will not work after December 31, 2017. The participant has until March 31, 2018 to submit expenses for services incurred through December 31, 2017. Even though the debit card is no longer an option for the participant, he can submit reimbursement requests from 2017 using our paper form or uploading through his online account or the Discovery Benefits mobile app. Discovery Benefits will reach out to the participant with this information and to answer any questions he may have.

Discovery Benefits is a third party administrator that provides reimbursement account administrative services on behalf of employers pursuant to service contracts with the employer. The plans in which this participant is enrolled are employer-sponsored plans governed by IRS regulations and plan...

rules as defined in the employer’s plan document and summary plan description.  IRS rules governing substantiation requirements for the flexible spending accounts (FSA) require that all claims must be substantiated, even those paid using the debit card. See 1.125-6(b)(2) and 1.125-6(3)(i).  Discovery Benefits will also provide an additional written response directly to the participant regarding his complaint.

Discovery Benefits is a third party administrator that provides COBRA administrative services on behalf of employers pursuant to service contracts with the employer. Discovery Benefits is not an insurance carrier and does not have access to or control of the records or processes of insurance...

carriers. According to its standard process for communicating eligibility to carriers, on December 12, 2017 Discovery Benefits notified the carriers of the reinstatement of this participant’s coverage effective November 2, 2017. As a result of phone calls from the participant, Discovery Benefits reached out to the vision carrier three additional times on January 8, 2018, January 18, 2018 and January 25, 2018.  Discovery Benefits received confirmation from the vision carrier of the reinstatement of the participant’s coverage effective November 2, 2017 with no lapse in coverage on January 25, 2018.

Initial Business Response /* (1000, 5, 2015/07/21) */
The participant emailed Discovery Benefits on November 19, 2014. To ensure the security and privacy of participant information, Discovery Benefits' process requires that there must be verification of three identifying items from the participant...

in order to provide the requested information. As Discovery Benefits was not able to verify three items from this email, a response was sent requesting additional information. The participant responded and a debit card was ordered for the participant according to her request.
The participant emailed Discovery Benefits on December 19, 2014 with a general question regarding eligible expenses under the type of plan in which she was enrolled. Additional identifying information was not required to respond to this email because of the general nature of the information.
Discovery Benefits received an email from the participant on February 11, 2015 in which she indicated her employment was ending on February 13, 2015. Discovery Benefits responded on February 13, 2015 requesting additional information because the email did not include three identifying items. A response was never received from the participant.
The participant emailed Discovery Benefits on May 26, 2015 inquiring how to access her funds. Discovery Benefits responded on May 29, 2015. The participant was advised that she had 180 days from the date of the receipt to file claims. The participant was also advised that claims are required to be filed through the online account, mobile app or via the debit card.
On June 1, 2015, Discovery Benefits' system was updated by the employer to reflect the participant's termination date of February 1, 2015. Because of her termination date, her final filing date for any claims was May 1, 2015 according to the terms of the plan document.
The participant called Discovery Benefits on July 2, 2015. Discovery Benefits advised that the runout period for the plan was 90 days and the funds had been forfeited.

Discovery Benefits is a third party administrator that provides COBRA administrative services on behalf of employers pursuant to service contracts with the employer. Discovery Benefits does not sell directly to individuals and does not have individual service agreements with employees,...

participants or qualified beneficiaries.
Discovery Benefits is not an insurance carrier and does not have access to or control of the records or processes of insurance carriers.
According to its standard process for updating eligibility with carriers, Discovery Benefits notified the carrier of the reinstatement of coverage for this participant effective September 1, 2016 on October 11, 2016, the day after the participant’s enrollment was completed.
Discovery Benefits was notified by the participant on November 16, 2016 the coverage was not showing active with the carrier. Discovery Benefits contacted the carrier on November 17, 2016 and again on November 28, 2016 to confirm coverage for this participant. When the carrier was unresponsive, Discovery Benefits contacted the former employer of this participant and requested assistance in communicating the reinstatement.
Discovery Benefits received confirmation from the employer on December 16, 2016 of the reinstatement of coverage for this participant effective September 1, 2016. The employer also provided an ID number for this participant. If necessary, the participant should contact Discovery Benefits to obtain this ID number.

It is DBI's policy not to include detailed information in its Revdex.com responses in order to protect an individual's privacy.  A letter was mailed to the individual yesterday.  In the letter, we provided detail regarding the paperwork submitted and noted that the outstanding check originally issued to the accountholder has been voided and another check will be issued in the same amount payable to the estate of the accountholder. The check will be mailed to the address we have on record for the accountholder's HSA by the end of the week.

Discovery Benefits is a third party administrator that provides reimbursement account administrative services on behalf of employers pursuant to service contracts with the employer. Discovery Benefits does not sell directly to individuals and does not have individual service agreements with...

employees or participants.   Discovery Benefits received the first notification the check was not received or cashed by the intended party on April 10, 2017. Discovery Benefits is working with its bank to recover the funds in order to re-distribute the funds to the participant.   We apologize for the conflicting information provided by a Discovery Benefits customer service representative.  Steps have been taken to ensure appropriate responses are provided moving forward.   A Discovery Benefits customer service representative has been in contact with the participant regarding next steps toward resolution of this matter.

Initial Business Response /* (1000, 5, 2015/05/26) */
We are in receipt of direct correspondence from this individual concerning another individual's coverage and are mailing a letter directly to the covered individual in this matter.
Discovery Benefits provides COBRA administrative services...

for the former employer. Discovery Benefits is not an insurance carrier and does not exercise control over the records of insurance carriers. Discovery Benefits remits premiums it receives from qualified beneficiaries to the employer on a monthly basis.
Discovery Benefits received and processed the individual's election form on February 13, 2015. According to standard process, Discovery Benefits notified Blue Cross Blue Shield of Texas (BCBSTX) of the reinstatement of coverage effective February 1, 2015 on February 18, 2015 using the contact information provided to us on behalf of the former employer.
Discovery Benefits was first advised that coverage was not active on March 3, 2015. Because the standard processing time of 15 business days had not yet passed since the initial enrollment, Discovery Benefits did not re-submit a request to the carrier at that time.
Discovery Benefits received notification on March 24, 2015 that coverage was not updated with the carrier. The Discovery Benefits representative advised that the carrier could contact Discovery Benefits directly. Discovery Benefits received a call from a BCBSTX representative on March 26, 2015. The representative indicated that coverage was not yet updated in the BCBSTX system. When the Discovery Benefits customer service representative confirmed the contact at the carrier, the BCBSTX representative did not suggest that it was incorrect, only asked that the information be sent again.
Discovery Benefits received three calls from a different representative with BCBSTX on April 1, 2015. This representative inquired as to how the information was being sent to BCBSTX as the information was still not updated in their system. Discovery Benefits sent another urgent update request to BCBSTX while on the phone with this representative. During the last call with this representative, she provided a different contact email address. Discovery Benefits sent another request to the email address provided.
Discovery Benefits received confirmation on April 6, 2015 that coverage had been updated.
According to our standard process, Discovery Benefits notified BCBSTX on May 11, 2015 of the termination of coverage effective April 1, 2015 due to the non-payment of premium.
Discovery Benefits received an email on May 19, 2015 indicating that BCBSTX had not received any notification from Discovery Benefits. Discovery Benefits reached out to BCBSTX again to confirm coverage on May 20, 2015. Discovery Benefits received confirmation from BCBSTX again on May 21, 2015 that coverage had been reinstated.