*FOR ISB USE ONLY*

Member Enrollment Document

Welcome to the Veridian Fiscal Solutions (VFS) enrollment platform! The following screens will guide you through the information we need to successfully enroll you as an employer of record in the Consumer Choices Option (CCO) Program.

VFS is the Financial Management Service (FMS) for the CCO Program. As the FMS, our duties include:

• Facilitating the member enrollment process
• Issuing payments to your employees and providers
• Ongoing support for questions regarding your CCO account with Veridian

Our Communication Promise

At VFS, we value the importance of communication with our members. We strive to respond to our members promptly and want to be a partner in this enrollment process. We are committed to responding to your questions within 48 hours.

Our business hours are Monday through Friday, 8 a.m.- 5 p.m. with the exception of holidays.

We can be contacted via phone or email.

✔Phone: (866)226-4692
✔Email: ccoiowa@veridiancu.org

Member Agreement

Veridian Fiscal Solutions (VFS), a wholly owned subsidiary of Veridian Credit Union, is the financial management service (FMS) for the Consumer Choices Option (CCO) program. The Managed Care Organizations (MCOs) and Iowa Medicaid administer the CCO program. This agreement describes each party's responsibilities. These things are important for you to know when self-directing your services through CCO.

 Your responsibilities (CCO Member):

• Recruit, hire, and train all employees you wish to hire and terminate when necessary.
• If you already have an EIN, notify VFS immediately. When you leave CCO also notify VFS to terminate the EIN.
• Decide on pay rates within labor laws and your monthly budget amount.
• Check and approve all employee hours to make sure they are within your monthly budget amount.
• Look at the monthly statements to make sure they are correct. Contact VFS within 30 days to fix any errors.
• Follow all required state and federal labor laws as an employer. This includes, but is not limited to, paying employees' minimum wage.
• Create an emergency plan, which is used when an employee is not able to work.
• You are responsible for paying any employee wages that go over the amount in your budget. Iowa Medicaid, your MCO, and VFS cannot process this payment and are not responsible for the payment.
• Verify all potential employees’ citizenship or alien statuses and provide I-9 documentation to VFS.

Veridian’s responsibilities:

• Handle all CCO member and employee paperwork and be available for questions.
• Assign an Employer Identification Number (EIN) for the CCO member and close the EIN if the member leaves the program.
• Complete a background check on all potential employees.
• Provide an online system for employees to enter hours and for CCO members to approve hours.
• Check the monthly budget expenses to make sure they match up with the CCO member’s budget.
• Handle payroll, which is done two times each month.
• Withhold, file, and pay all employer taxes and income withholdings, including Medicare, Social Security (FICA), federal (FUTA), and state (SUTA) unemployment and disability insurance taxes that apply.
• Refund over-collected FICA, when appropriate, to the employees of the CCO member, the Iowa Medicaid, or MCO.
• Manage all judgments, garnishments, tax levies, or withholdings on an employee’s pay (as required by federal, state, or local laws).
• Make statements available to the CCO members and their Independent Support Brokers each month.
• Distribute Internal Revenue Service Forms W-2 and W-3 and 1099 each year.
• Process any returned payments in accordance with the Abandoned Property Laws.
• Send in and renew workers’ compensation paperwork on behalf of the CCO member. This policy is written in the CCO member’s name and provides certain benefits to employees who receive injuries during the course of their employment.
• Give individuals multiple ways to share comments and ask questions.

MCO/Iowa Medicaid responsibilities

• Provide payment to VFS for CCO members’ services, approved monthly budget expenses, and non-budget expenses (e.g., workers’ compensation insurance policy).
• Talk to CCO members about their needs and help them decide on a monthly budget amount.
• Keep track of services used to make sure CCO members’ needs are met.

Important information

• Self-directing your services is your choice. If at any time you decide self-direction is not the right thing for you, you can go back to traditional services.
• You are the common-law employer. Iowa Medicaid, your MCO, and Veridian are not the common-law employers and are not responsible for your (or your legal guardian’s) actions as the common-law employer.
• If you switch between an MCO and Iowa Medicaid, all the paperwork VFS has for you will be available to the new entity.

Workers’ compensation insurance is required.

• Workers compensation insurance is paid for by Iowa Medicaid, or the MCO. All paperwork will be submitted by VFS to apply for and renew your coverage.
• Workers’ compensation claims should be sent directly to the insurance carrier. Do not send claims to Iowa Medicaid, your MCO, or Veridian.
• Workers’ compensation insurance covers an employee who is hurt while they are working for you. It does not cover an injury to you while an employee interacts and works with you.
• Your MCO, Iowa Medicaid, and Veridian are not responsible if an employee is injured while working for you.

You must have an Unemployment Tax Insurance Account.

• The cost of this insurance is part of your employer's tax rate. It can be found on the budget form.
• If an employee is fired, they can file for unemployment benefits through Iowa Workforce Development.
• If unemployment benefits are given to an employee, this could raise your employer's tax rate. This rate can be found on the budget form.

The CCO member certifies that he or she has read and understood the information presented in the member agreement and agrees to be bound by his or her responsibilities. The CCO member agrees to follow the policies of the Fiscal/Employer Agent, Veridian Fiscal Solutions, the Department of Human Services, Iowa Medicaid, and the MCOs.

The CCO member also consents to the use and disclosure of information received by VFS about the member, including health information provided by the member and/or information about health services received by the member, as necessary to meet VFS’s responsibilities under this Agreement.

As a CCO member, I have received clarification on the information that I did not fully understand.

Do not refresh your browser while completing the application. Doing so will lose your progress, and you will need to restart the application. 

You can elect a representative as your Delegation of Budget Authority (DBA) to assist with program and employer responsibilities. They will be authorized to complete the following tasks:  

• Review and sign budgets that allocate the monthly budget amount according to your service plan.
• Approve payment(s) for employee hours worked and vendor service(s) provided.
• Sign contracts on your behalf, including those needed for the person or entities that will provide services and support to you.
• Determine the amount to be paid for services. Please note that Iowa Administrative Code 441-79.1(2) outlines payment requirements for the ISB.
• Work with your employees on a schedule to provide services to you.

When deciding if a DBA is needed, please keep the following in mind:

• Members under the age of 18 with a parent or guardian signing the state and federal forms will need to be assigned a DBA.
• Members are not required to appoint a DBA if they will sign all their own documents.
• I will not be paid to be the personal representative.
• Cannot provide direct service to the member.

By clicking here, you attest that the delegation of budget authority (DBA) can access your Veridian Fiscal Solutions account and act on your behalf. This access includes, but is not limited to, account balances, time sheets, enrollment documents, payment requests, budgeting documents, employee and vendor information, authorization documents, billing, and claims information. This access includes confidential and protected health information.

You may revoke or change your account authorization at any time by submitting the Account Authorization form or by contacting us at CCOIowa@veridiancu.org

You understand that the DBA must be over the age of 18, cannot be paid for their services (per program rules), and cannot provide direct service to you.

Veridian will need to contact you regarding your enrollment status now and in the future regarding your Consumer Choices Option (CCO) services, payments, and for other purposes. Many of our communications are sent through email. 

Please provide your contact information below:

• Email
• Cell Phone
• Home Phone

By providing my email and phone number(s) and signing the member agreement, I am providing expressed written consent to Veridian and its affiliates or anyone contacting me on their behalf to call, text, and/or email regarding my CCO services at any phone number and email address provided to Veridian. You agree that we may leave messages on your voicemail. You certify that the telephone number(s) and email address provided to us are your contact information. You understand your cellular or mobile phone provider may charge you for such contacts according to the type of plan you carry, and Veridian is not responsible for any such charges. You further agree that methods of contact may include the use of pre-recorded or artificial voice messages and/or use of an automatic dialing device. You agree to notify us of any change to any phone number(s) that you have provided to us and agree that we may contact you if, in the future, you make any changes or updates to the email address or phone number(s) you have on file with us. You may revoke this access at any time by any reasonable means, including by contacting us via phone at (866) 226-4692 or email at ccoiowa@veridiancu.org

Providing account authorization will grant access to your Veridian Fiscal Solutions account. Access will include, but is not limited to:

• Account balances
• Employee and vendor information
• Billing and claims information
• CCO Documentation

Access will include confidential and Protected Health Information.  You may revoke or change your account authorization at any time by submitting the Account Authorization form or by contacting us at CCOIowa@veridiancu.org. I understand this access will remain until I change or revoke the granted access.

If yes, you will be prompted to add information for the individuals being granted access to your account after hitting the submit button on your application.

Please be sure you have the following information ready for each individual being granted access to your account, as you will be required to enter it at that time:
• Name
• Email address (if applicable)
• Phone number (if applicable)

Upon completion of the Member Packet, a link to the Electronic Employee Application will be provided to begin the application process.

Once the employee application has been submitted, VFS will perform a background check on your prospective employee. You will be notified if the prospective employee is approved based on their background check or if further information is needed to determine if they are eligible to be an employee in the CCO program. This determination is made by the Department of Human Services.

Any information regarding your employee’s approval or denial will be sent to you, people authorized on your account, and your ISB via secure email.

Do not have your prospective employee begin work prior to being notified by VFS that they are approved. Hours worked prior to the approval date provided are not eligible for payment through the CCO program.

At this time, please click on the Preview PDF button and review the information on the Member Enrollment Form.

Do not close out of the PDF.

After reviewing your information, please click on the Back to Form button in the upper left-hand corner of the page.

If any of your information is incorrect, click the Back button to navigate to the appropriate page for editing.

If your information is correct, click the Submit button to send your application to VFS.