- HRA Eligibility
- Health Plans and HRAs
- Drug Price Search Finders
- HRA Glossary
- HRAs vs. FSAs
- View your HRA Benefit
- mySource Debit Card
HRAs must be linked to group medical plan. Therefore, in order to be eligible for the HRA you must be enrolled in your employer group plan.
An HRA is totally funded by the employer. The employer decides (1) how much they want to contribute to the HRA and (2) what expenses they wants to pay for (i.e. deductible only). After that, you have control on how and when you spend the money. After incurring the eligible expense, you will submit a claim for reimbursement.
You should receive a Summary Plan Description describing the HRA(s) and your rights and responsibilities as a participant.
How will an HRA work with my current health care plan?
An HRA must be “linked” to a health plan. A linked HRA is typically designed to reimburse the employee for co-pays and/or deductibles associated with the underlying medical plan.
How do I pay for the out-of-pocket expenses?
The expense must be incurred before you submit a claim to be reimbursed, but the expense does not have to be paid before reimbursement. At the time the expense is incurred, if the services are applicable to your medical deductible, employees should not be responsible to pay at time of service.
Will I have to change doctors?
The HRA itself does not limit your access to healthcare by restricting access to physicians or other healthcare providers.However, if the HRA is designed to work with your health plan, you will need to use the physicians or networks required by the health plan or face additional charges.
Conserve your HRA dollars by finding your RX at the lowest price point! Remember it’s about quality. The tools provided below allow to find your RX at the lowest price point and not sacrifice the quality. Who doesn’t want that!
- GoodRX Drug Price Finder
- NJ Drug Price Finder
- PA Drug Price Finder
- Wal-Mart Drug Price Finder
- Target Drug Price Finder
Let’s be real…understanding health insurance is like learning a foreign language! Below is a list of simplified insurance terms that may apply to your HRA benefit with O.C.A. Benefit Services.
Health Reimbursement Arrangement (HRA): Is a pre-tax reimbursement benefit that will reimburse you for certain out of pocket medical expenses. The HRA is funded by your employer!
Claim Form: Employees must complete a HRA Claim form in order to be reimbursed. O.C.A.’s claim form can be done either via paper, online, or via our mobile app.
Explanation of Benefits (EOB): An EOB is not a bill. It’s a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were allowed by the insurance plan as well as identifying what the patient may owe to the doctor. Employees must submit the EOB to O.C.A. in order to be reimbursed.
Deductible: Is the amount you owe for health care services that your health insurance covers before the insurance plan begins to pay. For example, if your deductible is $1,000, your insurance plan won’t pay anything until you’ve met your $1,000 deductible for covered health care services.
Coinsurance: Is your share of the costs for a covered health care service, calculated as a percentage (for example, 20%). For example, if the health insurance allowed amount for an office visit is $100 and you’ve met your deductible, your coinsurance payment of 20% would be $20. The health insurance plan pays the rest of the allowed amount. In this case, $80.
For a full list of terms go to www.healthcare.gov/glossary
Can I participate in both an FSA and HRA?
Yes, if your employer sponsors both an FSA and an HRA, and you meet the eligibility requirements.
You can access your HRA benefit by logging into your myRSC account Click here to login or set up your account.
You can also download O.C.A.’s mobile app and access benefit information via your smartphone. The app is available in google play or the ITunes Store. The app is call myRSC!
All mySource transactions must be substantiated in order to confirm that all items paid for with pre-tax dollars are eligible under the IRS guidelines.
Depending on what your mySource card purchase was used for, may or may not necessitate the need for you to submit a claim form and documentation to support your purchase. This is an IRS requirement. For audit purposes, you should always retain your receipts!
Examples of automated substantiation (no follow-up “should” be required):
- Purchases that are made at retail stores (i.e. CVS, Target, Wal-Mart) with an federally approved point of sale approval system (IIAS) in place that restricts purchases with your pre-tax dollars to FSA eligible expenses.
- Purchases that match a known co-pay amount for health, vision or dental plan you have elected through your employer. If your insurance plan has co-insurance or deductibles, you can use the card to pay for these expenses, but you will ALWAYS be required to provide documentation to substantiate your purchase.Below is an example of a transaction that would require you to submit a claim form and documentation.
A health reimbursement arrangement (HRA) is an employer-funded arrangement that reimburses employees and dependents (if applicable) for certain healthcare expenses…
Typically, an employer creates a notional (i.e., unfunded) arrangement for each participating employee and then reimburses the employee for substantiated, qualified healthcare expenses up to the employee’s HRA account balance. While note required, a Health Reimbursement Arrangement (HRA) is usually offered in conjunction with a High Deductible medical plan which significantly lowers the insurance premium. A portion of this premium savings is used to reimburse plan participants when unreimbursed qualified expenses are incurred.
O.C.A. believes that qualify healthcare is less expensive to deliver than poor qualify healthcare. Finding your prescriptions is a perfect example our core message.
Did you know that different pharmacies charge different prices for the exact same drug? For example, a 500MG Amoxicillin capsule recently ranged in price from $0.11 to $11.36 per pill! Could you ever imagine paying $11.36 more per gallon of gas than you had to at a station right across the street? Of course not! Unfortunately, in our current healthcare system, we as consumers have been removed from seeing the prices.
Generally, the HRA is an employer provided reimbursement arrangement. The HRA works as follows: • The Employer establishes a notional agreement called a Health Reimbursement Arrangement for each Participant.• Each Plan Year, the Employer allocates a specified amount of employer contributions, called “HRA Dollars”, to each Participant for reimbursement of Eligible Medical Expenses.
While you are an active employee, the Employer allocates HRA Dollars to you. You do not contribute to the HRA (except during Federal Cobra). In fact, federal laws prohibit you from contributing to your HRA with any portion of a pre-tax salary reduction made under a Code Section 125 cafeteria plan. You may, however, be required to pay the “applicable premium” for continuation of HRA coverage under Federal Cobra.
You can obtain a reimbursement claim form from O.C.A. Benefit Services. You must complete the reimbursement claim form and submit it to O.C.A. with an Explanation of Benefits (“EOB”) * from the Administrator of the Component Medical Plan. In the event the HRA covers expenses other than expenses that would otherwise be covered by the Component Medical Plan but for a limitation (e.g., deductible, co-insurance), you must provide a written statement or, if no EOB is provided, a written statement from the service provider. The written statement from the service provider must contain the following: a) the name of the patient, b) the date service or treatment was provided, c) a description of the service or treatment; and d) the amount incurred. You may submit requests for reimbursement of Eligible Medical Expenses at any time prior to the end of the Run Out Period described in your Summary Plan Description. Requests for reimbursements submitted after the Run Out Period will not be reimbursed.*An EOB is document provided by the carrier or health plan that explains the amounts, if any, paid under the Component Medical Plan.