All processing of Membership Enrollment Forms is handled by your benefits/payroll office. The HRA VEBA Membership Enrollment Form should be completed and delivered to your benefits/payroll office.

Your HRA VEBA account is opened when your employer sends funds to the HRA VEBA third-party administrator (TPA with your completed and signed Membership Enrollment Form.

After your account is opened, you may submit an HRA VEBA Claim Form for your out-of-pocket medical, dental, or vision expenses or premiums incurred by yourself, your spouse, and/or your qualified dependents. Eligible expenses and premiums are defined in Internal Revenue Code (IRC) Section 213(d). 

Click here to view Definition of a Dependent

You may file claims at any time and for any amount. Benefits will be paid until your account is used up. You may also arrange to have monthly insurance premiums automatically paid by using the HRA VEBA Systematic Payment Form.

NOTE: Reimbursable health related benefits must be for expenses incurred after your HRA VEBA account is opened. Withdrawals from your HRA VEBA account may be made only for qualified medical, dental, or vision expenses/premiums or for tax-qualified long term care insurance premiums. Qualified dependents are defined in IRC Section 105(b) and described in IRS Publication 502.

The HRA VEBA TPA will provide you with a semi-annual statement detailing all activity in your account. This statement will be mailed to your home address. If you have any questions about your HRA VEBA account, or about a pending claim or need claim forms, call or write the HRA VEBA TPA. You may also call or e-mail and request a Participant Activity Statement at any time.

Filing Claims

Participants may request reimbursements by submitting a properly completed and signed Claim Form along with proof of claim to the HRA VEBA TPA, REHN & ASSOCIATES. 

Reimbursements or payments of recurring medical, dental, vision and/or tax-qualified long-term care insurance premiums may be requested using a Systematic Payment Form. Insurance premiums that are paid by an employer or that are or could be paid through a pre-tax Section 125 cafeteria plan are not eligible for reimbursement. If you are a participant in a Section 125 healthcare flexible spending account (FSA), you must exhaust your FSA benefits before submitting an eligible claim.

IRS Definition of Qualified Expenses and Premiums

Internal Revenue Code Section 213(d) defines qualified expenses, in part, as “medical care” amounts paid for insurance or “for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body…”  To be eligible, these expenses must be to alleviate or prevent a physical defect or illness.  Expenses solely for cosmetic reasons generally are not considered expenses for medical care.  Examples include facelifts, hair transplants and hair removal (electrolysis).  Expenses that are merely beneficial to your general health (e.g., vacations) are not expenses for medical care.  One fact or circumstance that often, but not always, indicates that medical care involves the treatment or prevention of disease is whether the care is prescribed by a physician.  A mere suggestion by a physician probably is not enough.  In addition, there should be a doctor-patient relationship between you and the physician prescribing the care, and the physician must be properly licensed.

Over-the-Counter (OTC) Medicines and Drugs

Quantities purchased for reimbursement should be limited to reasonable quantities expected to be consumed in a reasonable period of time. Typically, two bottles of an item in any one reimbursement is the limit. Sales tax on OTC items purchased can be included in the reimbursement. “Covered Items” include OTC drugs, medications and treatments intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease or injury. “Dual-purpose Items” may have a medical purpose and a personal/cosmetic or general health purpose.  In this case, attach a note to your Claim Form from a licensed medical provider stating the beneficiary had a specific medical condition for which the item was purchased.  “Excluded Items” are those used primarily for general health and well being.

The list of Qualified Expenses summarizes the more common allowable claims. If you have a specific question, please direct it to the HRA VEBA TPA.

Click here to view a list of Qualified Expenses.

In addition, you must submit proper substantiation of your claim, such as an itemized receipt for services, co-pay slip, or Explanation of Benefits (EOB) form provided by your insurance company.

Click here to view Participant Claim Documentation Requirements