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Discovery Benefits Reviews (99)

Due to the amount of information required to provide a detailed response, Discovery Benefits is sending a letter directly to the participant in response to this complaint

Discovery Benefits is a third party administrator that provides reimbursement account administrative services on behalf of employers pursuant to service contracts with the employerDiscovery Benefits does not sell directly to individuals and does not have individual service agreements with employees or participantsIRS 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 requirements1.125-6(b)(2) All claims must be substantiatedAs a precondition of payment or reimbursement of expenses for qualified benefits, a cafeteria plan must require substantiation in accordance with this sectionSubstantiating only a percentage of claims, or substantiating only claims above a certain dollar amount, fails to comply with the substantiation requirements in §1.125-and this section1.125-6(3)(i) In generalAll expenses must be substantiated by information from a third-party that is independent of the employee and the employee’s spouse and dependentsThe independent third-party must provide information describing the service or product, the date of the service or sale, and the amountSelf-substantiation or self-certification of an expense by an employee does not satisfy the substantiation requirements of this paragraph According to its standard process regarding substantiation, Discovery Benefits emailed this participant two Receipt Reminders prior to denying claims and requesting repayment Even though debit card transactions may be denied due to lack of or insufficient documentation, the merchant remains paid When the debit card is suspended, the participant may still submit requests for reimbursement using an Out of Pocket Reimbursement Request Form, filing a claim online through the member portal or submit the claim via the mobile app Discovery Benefits will send a more detailed letter directly to the participant as well

I am rejecting this response because:The provided documents submitted proves the amount paid was the amount charged, and the date of service the transaction conducted I will happily provide the documents to the Revdex.com if they would like to see for themself

Discovery Benefits is a third party administrator that provides reimbursement account administrative services on behalf of employers pursuant to service contracts with the employerThe participant requested a replacement benefits debit card online When the card was received with his name on it, he cut up the card and requested a debit card in his wife’s name A new card was mailed to the participant in his wife’s name.Per the participant, the card has not been received, even though the address on file was verified as correct.The cards are sent in plain white envelopes and it may be the participant threw away the envelopes containing the debit cards sent previously thinking it was junk mail.We are attempting to contact the participant to try to assist him with his questions regarding the status of the debit card

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to meWhile the issue was resolved, I continue to be upset with what I had to go through in order for it to happen The response stating they took care of the situation on first contact is not accurate The final straw was a supervisor who stated I would not be talking to anyone else and that the situation would take care of itself in a few days She continued to be rude even when I stated I was going to contact Revdex.com She was the one who left a message for me stating the issue had been resolved and she was suddenly very nice when she called I truly believe the situation would not have been resolved that day had I not contacted Revdex.com

Discovery Benefits is a third party administrator that provides reimbursement account administrative services on behalf of employers pursuant to service contracts with the employerDiscovery Benefits does not sell directly to individuals and does not have individual service agreements with employees or participantsFlexible spending accounts (FSA) are employer-sponsored plans governed by IRS regulations IRS rules govern substantiation requirements for the FSA, including expenses paid using the debit card See 1.125-6(b)(2) and 1.125-6(3)(i) The employer-sponsored plan is also governed by the requirements included in the employer’s plan document and summary plan description The final service date for this plan’s plan year was December 31, Because of this, the participant’s debit card will only access fundsThe participant still has full access to the balance but any reimbursements from that balance will need to be filed using any one of the following methods: submitting a form, going online or through Discovery Benefits’ mobile appThe last day for the participant to file for reimbursement from the plan year is March 31, The plan under which the participant is enrolled allows for a carryover of unused funds up to the statutory limit of $This participant has forfeited no funds Discovery Benefits does not retain any funds forfeited by participants All forfeited funds are returned to the employer-sponsored plan.During this time of year when a large number of employers’ plan years come to an end our call volumes and wait times may increase at any given time during the dayWe place the utmost importance on customer service and strive to respond to calls from participants as quickly as possible and keep the wait times as short as possibleDiscovery Benefits also provides an email and chat option for participants through discoverybenefits.com

When a claim is filed for reimbursement, documentation that includes the date of service, type of service, and dollar amount of payment is required for each claim that is filed If the documentation provided for each claim does not include this information, the claim will not be able to be approved Debit and credit card receipts are not valid documents for substantiating a claim as it does not include all information required by the IRS Discovery Benefits processes over a million claims a month Systems are automated where possibleWe do not refer to previously submitted documentation each time a claim is filed, and it is the responsibility of the participant to submit eligible documentation for each claim, which in this case requires a copy of the contract If the participant were to use the debit card for the same amount each month to the same provider, our system would automatically approve those claims without documentation being required – this is because we know by the debit card transaction that payment is being made directly to the provider for a recurring amountThe participant has the following options available to them: use the benefits debit card provided by Discovery Benefits paying the same amount to the same provider for each month’s submission allowing for automatic approval, or submitting a copy of the contract with each manual claim along with documentation that includes the date of service, type of service and dollar amount

Discovery Benefits is a third party administrator that provides COBRA administrative services on behalf of employers pursuant to service contracts with the employerDiscovery 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 reimbursement account administrative services on behalf of employers pursuant to service contracts with the employerDiscovery 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 substantiatedAs a precondition of payment or reimbursement of expenses for qualified benefits, a cafeteria plan must require substantiation in accordance with this sectionSubstantiating only a percentage of claims, or substantiating only claims above a certain dollar amount, fails to comply with the substantiation requirements in §1.125-and this section 1.125-6(3)(i) In generalAll expenses must be substantiated by information from a third-party that is independent of the employee and the employee’s spouse and dependentsThe independent third-party must provide information describing the service or product, the date of the service or sale, and the amountSelf-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

Discovery Benefits is a third party administrator that provides reimbursement account administrative services on behalf of employers pursuant to service contracts with the employerIRS rules govern substantiation requirements for the flexible spending accounts, including expenses paid using the debit card See IRS Code Section 1.125-6(b)(2) and 1.125-6(3)(i)For this employer’s plan, the employer utilizes a debit card substantiation file feed If no match is received on the file feed within a specified time period, a Receipt Reminder is sent to the participant requesting documentationIn 2015, the participant had debit card transactionsOf those, were auto-approved at the point of sale, leaving two transactions requiring documentation In 2016, the participant had debit card transactions Of those, were auto-approved at the point of sale, leaving transactions requiring documentation In 2017, the participant has had debit card transactions Of those, were auto-approved at the point of sale, leaving transactions requiring documentation This participant received numerous notifications, has logged into the portal and contacted Discovery Benefits by phone numerous timesEach time he has been advised of the documentation requirement As of today, the participant has the opportunity to submit the required documentation for the and plan years The plan year is now closed so no outstanding documentation will be accepted We recommend the participant contact Discovery Benefits if he has questions about submitting the documentation for and Discovery Benefits does not retain amounts forfeited by participantsAll forfeited funds are returned to the Plan In addition, even though a debit card transaction is denied due to the lack of or incomplete documentation, the merchant remains paid

Initial Business Response / [redacted] (1000, 12, 2015/06/02) */ Discovery Benefits provides administrative services for the former employer of this participantDiscovery Benefits is not an insurance carrier and does not exercise control over the records of insurance carriers Discovery Benefits received and processed the election form and initial payment from the participant on May 1, that included the addition of dependents to the coverageDependent information was not provided at the time the participant's information was entered into the employer web portalAccording to Discovery Benefits' standard process, the former employer was contacted so that we could confirm the addition of coverage for the dependents Discovery Benefits notified the carrier(s) of the reinstatement of benefits for the participant and family on May 4, Because the dependents needed to be confirmed, no dependent information was passed [redacted] the carrier at that time Discovery Benefits received confirmation from the employer to add the dependentsThe dependents were added and the carrier(s) notified on May 21, Discovery Benefits reached out to the participant and provided confirmation of the carrier update on May 21,

I am rejecting this response because:There is NO plausible excuse for taking weeks to process a payment in the 21st century I'm torn whether I believe the malfesance of Discovery Benefits is attributable to being merely supremely incompetent or whether to being deliberately malicious Either way, their conduct is utterly inexcusable I have filed civil suit agaist Discovery Benefits seeking $10,in damages for no receiving service for the months paid and for mental anguish, pain and suffering due to their unexplainable delays and misinformationn Waiting to see how long their lawyers leave the judge on hold

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 descriptionThe participant used his debit card to pay for services on March 14, The financial institution that supports the Discovery Benefits debit card uses a pre-authorization status that may last between seven and ten business daysDiscovery Benefits does not have authorization to release the fundsAs the pre-authorized funds have now been released, the plan year has been credited.Because the account was credited once the pre-authorized funds were released, Discovery Benefits was able to move the claim filed for reimbursement on March 15, from the plan year into the plan yearThe funds are now available to be used for eligible services

Discovery Benefits is a third party administrator that provides COBRA administrative services on behalf of employers pursuant to service contracts with the employerDiscovery Benefits does not sell directly to individuals and does not have individual service agreements with employees, participants or qualified beneficiariesDiscovery 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 the carriers, Discovery Benefits notified the carrier of the reinstatement of coverage for this participant on September 28, Discovery Benefits sent urgent requests to the carrier on behalf of the participant on September 29, October 27, November 2, and November 3, Discovery Benefits received confirmation from the carrier of the reinstatement of coverage for this participant on November 4,

Initial Business Response / [redacted] (1000, 9, 2015/12/08) */ The participant submitted a claim via the participant online portal with a date of service of November 4, Discovery Benefits received documentation on November 5, The documentation did not include a type of service as required by the IRS and was denied with a request for the participant to call Discovery BenefitsDiscovery Benefits received additional documentation and a completed form on November 11, The documentation did not include a type of service and the form indicated products received rather than a service providedThe products noted on the form required additional information under IRS regulationsDiscovery Benefits received the additional information from the participant on November 23, with no other documentationOn November 24, 2015, an itemized document was submittedThe claim was initially denied; however, upon further review, the claim was approved on November 24, when all of the documentation was reviewed togetherReimbursement was sent to the participant on November 25, Discovery Benefits' Participant Services operates as an incoming call center to respond to inquiries from participantsThe phone lines are kept open to the extent possible for incoming callsWhen a supervisor is available at the time requested, the call is transferredIf no supervisor is available at that time, a callback request is processed and the participant will receive a call back from a supervisor within hoursWe understand this may frustrate some participants, but it is done so that participants who are waiting in the call queue to speak with a representative are not unreasonably delayed due to a participant needing to wait for a supervisor to be available

Initial Business Response / [redacted] (1000, 5, 2016/01/29) */ Discovery Benefits is a third party administrator that provides COBRA administrative services on behalf of employers pursuant to service contracts with the employerDiscovery Benefits does not sell directly to individuals and does not have individual service agreements with employees, participants or qualified beneficiaries Discovery Benefits' client, the former employer of this participant, became a client of Discovery Benefits effective January 1, Discovery Benefits was notified of the continuation of this participant on December 4, and mailed takeover information to the participant on December 8, Under COBRA, a domestic partner is not a qualified beneficiary and does not have independent COBRA election rightsAs a result, while the domestic partner is eligible to be covered as a dependent of a qualified beneficiary, if the qualified beneficiary does not continue coverage, under the regulations, the domestic partner is not able to continue on the coverage alone The participant first contacted Discovery Benefits on December 21, with questions regarding terminating his own coverage and continuing coverage for his domestic partnerThe participant was not provided complete information by the Discovery Benefits customer service representative The participant called Discovery Benefits again on January 7, asking how to remove coverage for himself while keeping it for his dependentThe customer service representative addressed the process required to accomplish the change in coverage but did not catch the fact that the dependent in question was a domestic partner and not a spouse Discovery Benefits reached out to the client on January 18, regarding this matter to ask if they would allow a domestic partner to continue COBRA on their ownThe initial response received from the client on January 25, was no, the domestic partner was not eligible to continue COBRA on their ownDiscovery Benefits called the participant on January 26, letting him know the client's decision On January 28, 2016, the client contacted Discovery Benefits stating that it would now allow the continuation of benefits for the domestic partner onlyThe account is currently being set up with coverage for the domestic partner as originally requested by the participant

Initial Business Response / [redacted] (1000, 5, 2015/10/12) */ Discovery Benefits is not an insurance carrier and does not have access to or control of the records or processes of insurance carriers The participant's COBRA election and initial payment was received and processed by Discovery Benefits on July 6, According to its standard process for reinstatement, Discovery Benefits notified the carrier on July 7, of the reinstatement effective June 1, Discovery Benefits did receive confirmation that the original notification was received and opened on July 8, The participant contacted Discovery Benefits by phone on July 22, and indicated his coverage was not active with the carrierThe Discovery Benefits' customer service representative indicated to the participant of the carrier processing time, which can take up to business days The participant again contacted Discovery Benefits by phone on July 29, indicating his coverage was not active with the carrierThe Discovery Benefits' customer service representative advised the participant that Discovery Benefits would send another update to the carrierDiscovery Benefits received confirmation that the notification to the carrier was received and opened on July 29, The participant requested that Discovery Benefits call his carrier and when he was advised that was not a possibility, he requested a supervisorThere was no supervisor available and a call back request was created to call the participant within hours (one business day) On July 29, 2015, a representative from the participant's carrier contacted Discovery Benefits and spoke to a representative from the Carrier Relations departmentThe carrier representative suggested another email address but did not advise the original email address was incorrectAnother email requesting the reinstatement was sent by Discovery Benefits on July 29, The employer sponsoring the group medical plan under which the participant was enrolled terminated the plan effective July 31, As a result, the participant's coverage was terminated effective August 1, On August 3, 2015, Discovery Benefits sent to the carrier confirmation of coverage for this participant from June 1, to July 31, Discovery Benefits received confirmation this notification was received and opened on August 3, The participant enrolled in the employer sponsored dependent care flexible spending account with amounts credited to the notional account each pay periodThe participant did not submit any claims to the planOn July 6, 2015, the employer notified Discovery Benefits of the plan's termination effective July 31, The employer advised Discovery Benefits that there would be no run-out period or grace period allowed for submitting claims as the business was closing The participant contacted Discovery Benefits on October 2, asking how to submit claims as the final filing date was showing as July 31, Since the final filing date had passed, the funds are no longer eligible for reimbursement and have been forfeited to the planDiscovery Benefits does not retain forfeited funds Initial Consumer Rebuttal / [redacted] (3000, 7, 2015/10/15) */ (The consumer indicated he/she DID NOT accept the response from the business.) Your response shows the lack of responsibility and desire to work in good faith You knew the plan was terminating and you knew there was a balanceWhy was there no attempt to contact me so that I could submit a claim for my funds? When the COBRA was not active, your representative refused to even look and see if the contact information was correct or notShe claimed it was against the lawThis is my information and it was verified whom I wasIf they had taken the time to do their job, I would not have been without coverage for that long of a period It is sad that it was only corrected once Blue Cross got involved I do not accept your response Final Business Response / [redacted] (4000, 9, 2015/10/16) */ Discovery Benefits is advised of the carrier contact information upon the employer's implementation of the Plan and any time there are changesDiscovery Benefits used the contact information supplied for this carrier when updating coverage on July 7, for this memberDiscovery Benefits does maintain documented confirmation of the receipt and opening of emailed notifications and can confirm the email containing this participant's information was received and opened by the carrier on July 8, Discovery Benefits does have in place a process for urgent updatesThis process is followed only after Discovery Benefits is notified by a participant that their coverage has not been updated after the expiration of business daysThe participant in this case contacted Discovery Benefits on July 29, at 12:p.mThe participant was advised Discovery Benefits would re-notify the carrierAt 12:p.mon the same day, Discovery Benefits was contacted by a representative from the carrier regarding this participantThe carrier representative suggested an alternate email address to which Discovery Benefits sent an urgent update request at 1:p.mon July 29, Regarding the flexible spending account, it is the employer's responsibility to determine the run-out period allowed for the Plan and if there are changes, communicate those changes to employeesInformation concerning the account was available to the participant via the online web portal and it is the participant's responsibility to monitor the status of their account balance

Discovery Benefits is a third party administrator that provides COBRA administrative services on behalf of employers pursuant to service contracts with the employerDiscovery 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, on October 11, 2016, the day after the participant’s enrollment was completed Discovery Benefits was notified by the participant on November 16, the coverage was not showing active with the carrierDiscovery Benefits contacted the carrier on November 17, and again on November 28, to confirm coverage for this participantWhen 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, of the reinstatement of coverage for this participant effective September 1, The employer also provided an ID number for this participantIf necessary, the participant should contact Discovery Benefits to obtain this ID number

Initial Business Response / [redacted] (1000, 5, 2016/03/15) */ 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. On December 29, 2015, Discovery Benefits sent notification of the participant's continuation to the carrier effective January 1, 2016. Discovery Benefits was notified by the participant on February 2, 2016 that her coverage was not showing as active. Following this call, Discovery Benefits sent an urgent update request to the carrier on February 3, 2016 to ensure coverage. The carrier responded with an email to Discovery Benefits on February 8, 2016 indicating the coverage update was complete. The participant contacted Discovery Benefits on March 9, 2016 regarding her coverage. She requested Discovery Benefits send another urgent update request to the carrier. Later in the day on March 9, 2016, a representative from the carrier contacted Discovery Benefits to confirm eligibility for the participant. The representative indicated there was a request in place for her coverage to be updated but it can take 48 to 72 hours for the coverage to be updated. The participant contacted Discovery Benefits by phone again on March 9, 2016. She was advised Discovery Benefits was in the process of confirming coverage with the carrier. Discovery Benefits sent another urgent update request to the insurance carrier to confirm coverage. Discovery Benefits received confirmation of the reinstatement of the participant's coverage effective January 1, 2016 on March 14, 2015.

Discovery Benefits provides COBRA administrative services on behalf of employers pursuant to service contracts with the employer Employers hire Discovery Benefits to administer COBRA in accordance with federal COBRA regulations and it is a requirement of our service agreements with employers that we do so This includes COBRA payment deadlines

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Address: PO Box 2079, Omaha, Nebraska, United States, 68103-2079

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