Benefits can be overwhelming. We’ll help you break down the basics of a Health Reimbursement Account (HRA) to ensure you are educated and not leaving money on the table.
First, it’s important to understand some basic terms we often use when talking about healthcare:
HRA = Health Reimbursement Account
FSA = Flexible Spending Account
HSA = Health Savings Account
EOB = Explanation of Benefits
HDHP = High Deductible Health Plans
Health Reimbursement Accounts are, “employer-funded group health plans from which employees are reimbursed tax-free for qualified medical expenses up to a fixed dollar amount per year. Unused amounts may be rolled over to be used in subsequent years. The employer funds and owns the arrangement.”[1] HRAs are generally integrated with a group medical plan, and there are many variations. We’ll touch on the two most common HRAs, a deductible HRA and post-deductible HRA.
Deductible HRA: This is employer-funded and is available on the first day of your medical coverage. There is no qualified deductible amount to meet in order to access the funds.
Things to know about a Deductible HRA:
-Since your deductible is funded as of the first dollar amount this does not make you qualified for an HSA.
-This HRA is generally integrated with an HDHP that has a higher deductible limit, therefore eligible claims will have to be applied to the medical deductible.
**For example: specialist and urgent care visits. Sometimes routine eye exams may fall into this as well.
-Flexible Spending Accounts, if offered by the employer, may be an option. This will allow you to use pretax funds to pay for your vision and dental claims that are not covered by the HRA.
-Find your medical insurance carrier’s website and set up a login. Whoever your administrator for the HRA, an Explanation of Benefits (EOB) would be needed to substantiate a claim. This is the easiest and quickest way to obtain the EOB.
**If you are submitting claims manually or using your card, keeping an EOB will allow you to be aware and keep you involved in the process.
-It is important to be mindful of what your group medical coverage includes; you may think medical is all-encompassing but that may not always be the case
If you have a basic vision benefit on your medical coverage, you can expect that an EOB may be required for a claim with your HRA administrator. Separately, if you use a card with your HRA funds, this may not go through on the card and will require a claim.
Post-Deductible HRA – With a post-deductible HRA, the employee must meet a “mini” deductible in order to open up the funds. The employer provides funds to help pay the remainder of the deductible (HDHP minimums for 2020: $1400 for Single Policies and $2800 for Family Policies[2] – check out our HSA blog post[3]).
Things to know about a Post-Deductible HRA:
-If the HRA starts after the qualified deductible amount, you are eligible for an HSA!
-The first $1400/$2800 will need to be tracked before the HRA funds are opened
-This may vary based on your HRA administrator. No matter what, it must be a claim that has been processed with your insurance carrier and applied to your medical deductible.
-Integrated with HDHP
-Eligible claims must be applied to the medical deductible with your insurance carrier.
-Get your EOBs and save them! They will be always necessary for an HRA.
-For the first deductible portion, watch the claims and make sure those that have been “applied” are not claims you will be using your HRA funds to pay. **During the tracking time, use your HSA if available.
-This HRA option may seem confusing, but once you get comfortable with the process it will be a great benefit! It is money provided to you as the employee to pay your medical expenses; make sure you use these accounts to their full advantage.
Benefits can be difficult to navigate, but that is what we
are here for! If you have any additional questions, please feel free to reach
out to us at info@bondbenefits.com
or give us a call at 585-248-5870.
[1] https://www.healthcare.gov/glossary/health-reimbursement-account-HRA/
[2] https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/irs-2020-hsa-contribution-limits.aspx
[3] https://bondbenefitsconsulting.com/maximize-your-hsa/