Using Your Account
Below is a list of frequently asked questions (FAQs) regarding the use of your account. If you cannot find what you are looking for, check one of the other FAQ categories: General Information; Funding and Benefits of Participation; or Investment Options.
When can I start filing claims?
You can file claims at any time for qualified expenses and premiums incurred after you enroll and become claims-eligible. Your claims-eligibility date will be either (1) the date specified to us by your employer; or (2) if no date is specified, the date upon which we have received both your online or paper enrollment and a contribution from your employer.
Are my legal spouse and qualified dependent(s) eligible for benefits?
Yes, your legal spouse and qualified dependents, including your young-adult children through the calendar year in which they turn age 26, are eligible for coverage. Read our Definition of Dependent handout to learn more. To get a copy, log in and click Resources, or request a copy from the customer care center.
What types of expenses are eligible for reimbursement?
Common qualified expenses include deductibles, co-pays, coinsurance, and prescription drugs. Retiree medical insurance premiums, including Medicare and Medicare supplement plans, and tax-qualified long-term care insurance premiums (subject to IRS limits) are also eligible for reimbursement. Read our Qualified Expenses and Premiums handout to learn more. To get a copy, log in and click Resources, or request a copy from our customer care center.
Can I use my account to reimburse retiree insurance premiums?
Yes. Medical (including marketplace exchange premiums that are not, or will not be subsidized by the Premium Tax Credit), dental, vision, tax-qualified long-term care (subject to IRS limits), Medicare Part B, Medicare Part D, and Medicare supplement plan premiums are eligible for reimbursement. Read the Qualified Expenses and Premiums handout to learn more. To get a copy, log in and click Resources, or request a copy from the customer care center.
NOTE: IRS regulations provide that insurance premiums paid by an employer, deducted pre-tax through a section 125 cafeteria plan, or subsidized by the Premium Tax Credit are not eligible for reimbursement. If requesting reimbursement of premiums deducted from your paycheck after tax, you must include a letter from your employer that confirms no pre-tax option is available.
Can I have my insurance premiums reimbursed automatically?
Yes. Automatic reimbursement of your monthly insurance premiums is available. To set up an automatic premium reimbursement, log in and click Claims, or submit an Automatic Premium Reimbursement form. Forms are available after logging in or upon request from our customer care center.
How long does it take to process a claim?
Standard claims processing time is five to seven business days from the day we receive your claim. If you are not enrolled in direct deposit, remember to allow adequate time to receive your paper check reimbursements in the mail.
Get your money back faster by submitting claims and supporting documentation online after logging in or by using our mobile app, HRAgo.
Is direct deposit available?
Yes, direct deposit is available and recommended. You will get your money back faster, and it is more secure and convenient than waiting for paper check reimbursements in the mail. Funds availability is subject to your banking institution's policies and procedures. To enroll, log in and click My Profile or submit a Direct Deposit Enrollment form. Forms are available after logging in or upon request from our customer care center.
Do I have to use up my account right away?
No, your unused account balance carries over from year to year. There is no annual “use-it-or-lose-it” requirement.
Who pays first, HRA VEBA or Medicare?
If you are still working and you, your spouse, or a dependent are on Medicare, you may be required to use up your HRA before Medicare will provide future benefits unless (1) you are separated or retired from the employer that made, or is making, contributions to your HRA; or (2) you have elected limited HRA coverage. To avoid problems receiving Medicare benefits if you are separated from service or retired, contact our customer care center to make sure your separation/retirement date is on file. If you are still working and have elected limited HRA coverage, Medicare will provide benefits without requiring that you first use up your HRA.
What is limited HRA coverage, and why might I need it?
Limited HRA coverage is an election that limits the types of expenses and premiums eligible for reimbursement from your HRA. You may want to limit your HRA account if:
You are a current employee and you, your spouse, or a dependent have coverage that you want to be primary to your HRA coverage;
You, your spouse, or a dependent would like to be eligible to make or receive contributions to a ; or
You, your spouse, or a dependent want to become eligible to receive a through a marketplace exchange.
More information is contained in the Plan Summary. To elect limited HRA coverage, submit a Limited HRA Coverage Election form. To get a copy of the Plan Summary or access forms, log in and click Resources, or contact our customer care center.
What happens to my account if I change employers, go on a leave of absence, or retire?
As long as you have met all claims-eligibility requirements, you may use your account until funds are exhausted. If you have a participant account under the Post-separation HRA Plan and, after separating from service or retiring, become re-employed by the employer that made or is making contributions to that account, you will not be eligible to file claims to your Post-separation HRA Plan account for medical care expenses, including premiums, you incur while re-employed.
What happens to my account if I pass away?
If you pass away, remaining funds in your account (if any) may continue to be used by your surviving legal spouse and qualified dependents to reimburse their eligible medical care expenses and premiums. Surviving spouses and dependents enjoy the same tax advantages as participants.
In the unlikely event you pass away with an unused account balance and have no surviving spouse or dependents, the executor of your estate can spend down your account by filing claims for any unreimbursed medical care expenses you may have incurred prior to your death. Remaining funds (if any) after all final claims have been reimbursed may be used to reimburse medical care expenses incurred by your non-dependent heir(s). Medical care reimbursements paid to non-dependent heirs may be taxable.
How often will I get a participant account statement?
Paper participant account statements are mailed in January and July. If you are signed up for e-communication in lieu of paper (recommended), participant accounts statements are generated quarterly, and we will notify you via email when statements are available for online viewing. To sign up for e-communication, log in and click My Profile, contact our customer care center, or submit an Account Change form. Forms are available after logging in or upon request from our customer care center.
What are the fees?
Plan expenses include claims processing, customer service, account administration, printing, postage, legal, consulting, local servicing, auditing, etc. To cover these costs, a monthly per participant fee of $1.50 (if claims-eligible) or $0.75 (if not claims-eligible), plus an annualized asset-based fee of approximately 1.10%, is charged to your account. The monthly fee is waived if your account balance is more than $5,000. In addition, a 0.25% asset-based fee discount applies to any portion of your account balance in excess of $10,000. Your account value changes daily based on activity, which includes investment earnings/losses, contribution and claims activity, and assessment of the asset-based fee.
To the extent permitted or required by law, certain fees, taxes or other assessments payable to the federal government under health care reform law may also be deducted from participant accounts. The Patient-Centered Outcomes Research Institute (PCORI) fee for the plan year ending September 30, 2019 is $2.45 per claims-eligible participant (the fee does not apply to spouses and dependents). The PCORI fee is pro-rated and deducted from claims-eligible participant accounts quarterly. The PCORI fee is imposed on all group health plans by federal health care reform and could increase annually through the 2019-20 plan year.