Beginning the Setup Process

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welcome

Welcome to Alerus Retirement and Benefits (Alerus). We appreciate the opportunity to provide employee benefit services for you and your employees. This guide will provide you with an outline of the documentation and information necessary to implement your FSA with Alerus.

Certain portions of this guide should be completed prior to the initial submission to Alerus. We will continue to use this guide as a reference tool throughout the setup and implementation process.

beginning the setup process

In order to begin the setup process, we ask that you first review and complete Sections II and III of this document. Once you have completed these sections, please return the updated version of this document to Alerus at .

IMPLEMENTATION TIMING

If you are implementing a non-calendar year plan, Alerus will need the completed implementation paperwork returned three weeks prior to the effective date. If you are requesting a January effective date, the completed implementation paperwork will need to be submitted in early November. Please see your sales person or account executive if a more detailed time frame is needed.

I. alerus service directory

consulting/Setup Assistance

Please contact your broker or agent, as applicable.

Roger Jorgensen, RHU, REBC

Health and Wellness Sales Consultant – HSA/FSA/HRA/COBRA/VEBA

19765 Hwy. 7, Shorewood, MN 55331

952.253.1259 ::

Implementation/setup

stacie ravenhorst, cfc

Implementation Specialist – FSA/HRA/HSA/VEBA

201 E. Clark St., Albert Lea, MN 56007

507.379.2812 ::

chris donovan

Implementation Specialist – FSA/HRA/HSA/VEBA

201 E. Clark St., Albert Lea, MN 56007

507.379.5702 ::

administration

michelle hintz, cfc

Health and Welfare Services Manager

201 E. Clark St., Albert Lea, MN 56007

507.379.2801 ::

april van hove, CFC

Supervisor – FSA/HRA/VEBA

201 E. Clark St., Albert Lea, MN 56007

507.369.5706 ::

Your plan will be assigned an administrator by the implementation specialist; you will receive this administrator’s contact information once setup is complete.

II. employer information

Employer Name / Today’s Date / Effective Date
Street Address / City / State / ZIP
Federal Tax ID / 6 Digit NAICS Code or Nature of Business / State of Incorporation
Type of Employer Entity (please check one)
C Corporation S Corporation Partnership Sole Proprietorship Limited Liability Company
Non-Profit Organization Government Church
Primary Contact / Title / Phone / Email
Billing Contact / Title / Phone / Email
Payroll Contact / Phone / Email
Payroll Frequency (Please Select)
Weekly Bi-Weekly 24 or 26 Semi-Monthly Monthly Date of 1st Payroll Deduction
Is payroll outsourced? / Is COBRA outsourced?
Yes No If yes, please identify vendor: / Yes No If yes, please identify vendor:
Broker (Agent) Name / Broker (Agent) Company Name / Broker’s Phone / Broker’s Email
Additional Contact(s) for Broker
Name: / Phone: / Email:
Alerus RM Contact Information
Name: / Phone: / Email:

III. plan information

FSA information

Approximate Number of Eligible Employees / Approximate Number of Participants
Benefits Offered
Health FSA Limited Purpose FSA Limited Purpose FSA with Post Deductible Expense
Dependent Care FSA Parking/Transit HSA
Plan Year / Mid-Year Takeover / FSA Contribution Annual Maximum
Begin End / Yes No / IRS Max Other $
Claims Processed Weekly On:
Monday Tuesday Wednesday Thursday Friday
Claims Run Out Period (after plan year and OR grace period end)
30 days 60 days 90 days Other
Debit Card Provided for FSA Plan / Debit Card Provided For
Yes No / Health FSA Dependent Care FSA
$500 Carryover Feature (Medical and Limited FSA Only) / Did carryover apply to previous FSA plan year?
Yes No / Yes No
2½ Month Grace Period? / If yes: / For
Yes No / 2½ months Other / Medical Dependent Care
Claims Funding Options (Section V.)
Option 1: Run on Alerus acct and ACH pull total back from employer Option 2: Run on employer’s acct
Additional Comments

IV. Participant census data

The following census data is required for the setup of your participants. This data should be submitted to Alerus in an Excel spreadsheet. Each bulleted item represents a separate column required in the spreadsheet. If a specific column does not apply, (i.e., division), simply leave that column blank.

HSA/FSA SPREADSHEET COLUMNS REQUIRED

§  Employee ID # (no dashes or spaces)

§  Last Name

§  Middle Initial

§  First Name

§  Social Security # (no dashes or spaces)

§  Address 1

§  Address 2

§  City

§  State

§  Zip Code

§  Country Code (US)

§  Email Address

§  Home Phone Area Code

§  Home Phone number

§  Date of Birth (M/D/YYYY)

§  Marital Status (S or M)

§  Gender (M or F)

§  Division (Optional)

§  Payroll Deduction Frequency

§  Payroll Effective Date (M/D/YYYY)

§  Date of Hire (M/D/YYYY)

§  HSA Coverage Level (S or F)

§  Annual Employee HSA Contribution

§  Annual Declared Amount – Dependent Care FSA

§  Debit Card (for Dep Care FSA) Y/N

§  Annual Declared Amount – Health FSA

§  Debit Card (for Health FSA) Y/N

§  Annual Declared Amount – Limited FSA

§  Debit Card (for Limited FSA) Y/N

The following columns are only required for participants electing to use direct deposit:

§  Bank Account Number

§  Bank Routing (ABA) Number

§  Checking/Savings

HOW TO SUBMIT CENSUS DATA TO ALERUS

The enrollment spreadsheet should be submitted to Alerus upon completion. Since this spreadsheet includes confidential information, you will need to submit via secure email connection.

You will be contacted by our implementation specialist once you have completed and submitted Sections II and III. Your implementation specialist will assist you with a secure file transfer or other secure method where you will submit your enrollment spreadsheet.

Please contact our implementation department at or 800.898.9344 with questions regarding this secure transmission.

V. plan funding

FUNDING options FOR THE fSA

The FSA employee contributions will remain in the employer’s bank account until they are needed for the reimbursement of claims. Following are the options available for funding claims payments for FSA. Please select the option you prefer.

Option 1 – alerus Account and ACH Pull
Reimbursement payments are drawn on Alerus’ bank account. The employer is sent a payment detail report via email. Alerus then pulls the total amount reflected on the payment report from the employer’s bank account. Checks are mailed the day following reimbursement processing and direct deposit notices are immediately emailed to the participants’ and the funds are withdrawn from the employer’s account one business day following the day they receive the payment report.
Option 2 – Employer Account
Reimbursement payments are drawn on the employer’s bank account using check stock provided by Alerus. Checks can be printed with employer’s choice of:
1) a signature electronically provided by the employer, or
2) no signature so employer can personally sign and distribute.
The employer is sent a payment detail report via email. Checks and/or direct deposit notices are immediately mailed to the participants’ homes or directly to the employer if a signature is required.

FUNDING REQUIREMENT FOR DEBIT CARD

Prefund Requirement

WexHealth, our debit card vendor, requires that employers provide five (5) percent of Health Flexible Spending Account (FSA) funding at the start of the plan year. This is known as the prefund requirement and this balance must be maintained throughout the plan year.

FOR EXAMPLE
An employer has 30 employees enrolled in the Health FSA and their total annual elections add up to $90,000.
Five percent of $90,000 is $4,500 so the prefund requirement is $4,500.

Why does the debit card vendor require the prefund?

Because Visa debits the vendor’s account daily for any transactions that take place; however, the card vendor only debits the employer’s account once per week.

Weekly ACH Debits

In addition to the minimum funding requirement, the employer will receive a weekly summary of the debit card transactions that took place during the prior week. This report will arrive via email every Monday and the debit card vendor’s bank, Bancorp Bank, will pull the total amount of these transactions from the employer’s bank account the following day.

Who will receive the email each week?

The email can go to as many individuals as the employer requests. Simply let your plan administrator know who should receive these reports and they will be set up accordingly.

Getting started

The first step in getting started is completing the Authorization for ACH Debits form for Bancorp Bank, the debit card vendor’s bank. This form should be completed and submitted to Alerus, along with a voided check. If your account does not have checks, please provide an authorization letter from your bank verifying the account and routing numbers for that account.

VI. plan document requirement

PLAN DOCUMENT FOR FSA

Flexible Spending Accounts are part of a Section 125 Cafeteria plan and do require a plan document and summary plan description. Alerus will provide a new Section 125 plan document (see applicable fees in your proposal). It is critical that the plan document is up to date and includes all items IRS regulations stipulate must be in a Section 125 plan document.

VII. ONGOING FSA ADMINISTRATION

plan administrator

Employers will be assigned an account manager who will be responsible for managing their plan. The account manager will serve as the employer’s main contact at Alerus and will keep the employer informed of any important information regarding their plan.

TERMINATED PARTICIPANTS

Employers should notify their Alerus account manager right away when a participant terminates employment so their account can be modified accordingly. The procedure after termination is dependent upon plan design, but in most cases participation ceases upon termination.

ADMINISTRATIVE INVOICES

Alerus processes invoices for administrative fees on a monthly basis. The setup fee is a one-time fee based on employee participation, and will be included on the first invoice. Alerus requires monthly invoices to be paid by EFT. Invoices are sent by email ten days before the EFT transfer occurs.

Invoice detail can be accessed online at alerusrb.com. You will be assigned a user ID and password for this website during the implementation process.

CUSTOMER SERVICE

Alerus is happy to assist you and your employees with any questions, requests or concerns regarding our services. Our customer service representatives are available Monday through Friday from 7 a.m. to 6 p.m. Central time at 877.661.4727.

Participants can access their accounts online at any time. Online, they will have the ability to review their balances and account history, request payment from their FSA, update personal information, and email Alerus customer service. Employers can also access participants’ account information online through our employer website.

USE OF THE HEALTH BENEFITS CARD

If your FSA participants are using the Alerus Health Benefits card, they will likely receive periodic requests to submit documentation for their purchases. It is important that new participants are made aware of this and other pertinent information related to the use of the card. Please see the enrollment material or your plan administrator for detailed information regarding the use of the Health Benefits card.

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