This article applies to you if you have a Via Benefits reimbursement account, sometimes known as a Health Reimbursement Arrangement*.
Your Reimbursement Account
A reimbursement account is provided in accordance with the terms specified in your benefit plan document.
Your former employer or benefits provider:
Sets the contribution amount and frequency for each eligible participant.
Determines any qualification requirements needed to access your funds. For example:
You may need to enroll in a specific plan type to initially qualify for funding.
Continued enrollment in that plan may be required to maintain funding.
Requesting a Qualification Exception or Appeal
If you believe your qualification status is incorrect, disagree with your contribution amount, or missed the opportunity to sign up for funding, you can contact Via Benefits to request a review of your account.
Many issues can be resolved quickly with the assistance of one of our representatives, who can fix errors or assist with submitting an exception request. You also have the right to file a formal written appeal. Note: Not all former employers or benefits providers allow exceptions or appeals.
Exceptions
Exceptions may be granted for extenuating circumstances, as defined by your plan rules.
You can request an exception by:
Calling customer service, or
Submitting a written appeal.
Appeal Requests
If you would like additional review or wish to request a qualification exception, you may submit a written appeal.
An appeal can’t be submitted by phone.
You must file your appeal within 180 days of the date you received notice of lost funding.
To help ensure timely processing, your appeal should include:
Account holder’s name.
Account holder's Social Security number (or the last 4 digits) and ZIP Code.
A detailed explanation of the reason for your appeal.
Clearly state why you feel the funding should be provided, reinstated, or reviewed.
Include any information supporting your request.
Supporting documents, such as proof of extenuating circumstances or a request for an exception to the plan rules.
Mailing Your Request
Send your written appeal to:
Attention: Appeals
Via Benefits
PO Box 981155
El Paso, TX 79998-1155
The plan administrator’s decision will be sent within 30 days of receiving your appeal.
If your appeal is denied, the response will include information on next steps.
Possible Extenuating Circumstances
Examples of situations that may qualify for an exception include:
You received incorrect information about eligibility, qualification, or enrollment requirements.
Changes in eligibility or qualification caused you to lose funding as of a specific date.
You weren't properly notified about initial or ongoing enrollment requirements.
You were unable to enroll within the required time frame due to circumstances beyond your control.
Examples
Physical or mental incapacity during the enrollment window.
Outdated contact information (mailing address, email, or phone) results in missed communications.
Coverage was issued after the enrollment period deadline due to timing with the insurance carrier’s application process.
Retirement occurred after the enrollment deadline.
Continued enrollment in group coverage past the enrollment deadline.
*Via Benefits reimbursement accounts are administered by Extend Health, LLC.