Below are some of the most commonly asked questions about HRAs. Click a topic and drill down to find the answer.
You can also find additional information on the What is an HRA page.
What is a Health Reimbursement Arrangement (HRA)?
An HRA is a reimbursement account set up and funded by your employer to cover eligible healthcare expenses as defined in the HRA Summary Plan Document. Unlike a healthcare FSA, in which the IRS defines the eligible services, your employer defines the services eligible for reimbursement from an HRA. Typically, an employer will reimburse deductible, coinsurance and copay expenses from your HRA, but not services such as medical, dental or over the counter drugs. An HRA can also cover all or a portion of your prescription drug expenses. Check your employer's HRA Summary Plan Document to see which types of services are covered under their HRA.
Are insurance premiums an eligible expense?
Usually they are not, but an HRA is a special kind of reimbursement account, so your employer may allow you to be reimbursed from your HRA for insurance premiums. Please refer to your employer's HRA Plan Document for coverage details.
If I terminate employment or retire, can I receive the remaining balance in my HRA?
No. However, you can continue to submit claims for reimbursement for services (or expenses) that were incurred prior to your termination date before the end of the run-out period (defined in your Summary Plan Description).
For example: Your plan has a 90-day run-out period following termination. Your termination date is September 13th. Your physician sees you on September 12th, but you do not receive the Explanation of Benefits from your insurance carrier until October 31st. You can still submit this expense as it was incurred prior to your termination date, and prior to the end of the 90-day run-out period following your date of termination. Any expense incurred after September 13 is not eligible.
If I terminate employment or retire can I be reimbursed for expenses incurred after my termination date?
Typically, in order to be considered an eligible expense, the expense must be incurred prior to your termination date. However, depending upon plan design, you may be able to continue your HRA coverage under COBRA or use funds during retirement. Please refer to your employer's HRA Plan Document for more details.
How do I enroll?
To enroll in an HRA, you must elect the option through your employer. With some plans, HRA coverage is automatically provided when you enroll in a specific health plan option, such as a deductible based PPO. Check with your employer's benefit department for more details.
Is my family eligible to enroll in an HRA?
It depends on the plan design. Frequently, an HRA is offered in a reimbursement account to cover healthcare expenses incurred by you or your family members covered under the employer's insurance plan. Check with your employer's benefit department for more details.
How do I contribute money to my HRA?
That's the best part of an HRA - you don't need to contribute any money to your HRA, as the funds are provided by your employer to offset certain out-of-pocket healthcare expenses.
What happens if I don’t use all the money in my HRA?
Unlike a healthcare FSA, which requires any unused funds to be forfeited, an HRA can be set up to roll your funds from one plan year to the next. If your employer offers "fund rollover", it will be described in your Summary plan documents.
The following description is how HRA fund rollover typically works: at the end of the plan year, you will have a certain amount of time ("run-out period") to submit claims for services incurred during the prior year. At the end of the run-out period, or at a date set by your employer, all or a portion of your remaining funds may rollover to the next plan year or to a carryover account. Your employer may set the following rules:
1) A Percentage of remaining funds may roll over, such as 50 percent. So, if you have $512 on the fund roll over date, you can roll over $256.
2) A Maximum amount may rollover, such as $250. Taking the example above, only $250 would roll over of the remaining $512.
3) A Percentage up to a Maximum, such as 50 percent up to $250. Again, $250 would rollover, using the above example. If you had $300 remaining, then only $150 would roll over (50% of $300).
4) All funds - all remaining funds may roll over to the next plan year.
What happens to the funds that are not rolled over?
Funds that are not rolled over remain in your HRA Account and can only be used for eligible expenses incurred during that plan year. You have until the end of the run-out period to submit claims for reimbursement from your prior year HRA.
How do I submit a claim reimbursement from my Health Reimbursement Arrangement Account?
Your HRA may offer an auto-payment option, which will automatically pay your eligible expenses from your HRA to you or your provider. Check your plan materials to see if this option is available to you. You may be able to opt-in or opt-out of this service through this website under the My Accounts section, once you are enrolled.
May I submit expenses for my spouse and children for reimbursement through my HRA?
Your HRA may stipulate that only expenses for dependents covered under the insurance plan are eligible for HRA reimbursement. Check your plan documents on claim eligibility.
What supporting documentation must I submit with each HRA claim?
There are two main types of supporting documentation for HRA claims.
i. Explanation of Benefits (EOB):
Each time you submit claims to your health insurance carrier, you will receive this statement detailing what the health plan will pay and what you must pay. For expenses that are partially covered under another insurance plan, you must attach a copy of both of the EOBs.
ii. Itemized Bills:
For expenses that are not submitted to another insurance plan, you must attach a copy of an itemized billing containing the following information:
- Name of patient
- Name and address of provider
- Description of service
- Date of service
- Amount of service
How do I know why my claim was denied?
You will receive an email or letter indicating the reason for the denial along with instructions for submitting the requested documentation.
Why may the amount of my reimbursement differ from the amount of my request?
1. The request is for more than the balance of your account. For example:
Annual Election = $1,000.00
Total Amount Disbursed to Date = $700.00
Available Balance = $300.00
Total Amount of Request = $500.00
You will only be reimbursed $300.00, as this is your available balance.
2. Your HRA covers a percentage of the eligible claim amount. For example, you have $300 in your account and you submit a claim for $100 that was applied to your medical deductible. Your plan reimburses 50 percent, so you will be reimbursed $50 (50 percent of the eligible amount).