An HRA is a type of healthcare account, funded entirely by your employer; employees cannot contribute to an HRA. It is designed to reimburse an employee for eligible medical expenses, as defined under IRS Code Section 213(d), incurred by the employee, his or her spouse and/or dependents. Though your plan may limit the expenses which are eligible for reimbursement, eligible expenses may include medical, dental and vision deductibles, insurance premiums, copayments and coinsurance as well as pharmacy expenses and some over-the-counter items. Per IRS guidelines, all medical expenses paid for with HRA funds must be substantiated. In general, HRAs have no "use-it-or-lose it" policy. The employer can specify at the beginning of the year whether funds remaining in a participant's HRA are either forfeited at the end of the plan year or whether funds can roll over and remain in the account from year to year.
The employer funds deposited into the HRA are not considered part of your income and therefore are not subject to income tax or FICA withholdings.
Participating in an HRA is a great way to stretch your healthcare budget. Typically an HRA sits alongside a health plan with higher deductible, coinsurance and copayment minimums; often these health plans have lower monthly medical premiums allowing you to save money. Some employers allow you to rollover and accumulate unused funds year after year. The more you save in your HRA, the more funds you will have to pay eligible medical expenses when they occur. An employer may also make the HRA portable so that you can take the funds with you when your employment ends or when you retire.
- Funding. Your employer contributes to your HRA upfront or on a pre-determined schedule throughout the year. (Please contact your Human Resources office for a copy of your employer’s contribution schedule.)
- Accessing Funds. When you have an eligible healthcare expense, pay for them with your healthcare payment card, or pay out-of-pocket and request reimbursement online. Remember to always keep your receipts.
- Requesting Reimbursement/Substantiating Purchases. Log on to your online account and visit the Claim Center.
- If your payment was out of pocket, you will click "Make a Payment/Add a Claim" and follow the instructions to enter the required information. Then print out your Claim Form and use it as a fax cover sheet to send it and your receipts to the number shown on the form.
- If the purchase was made using a healthcare payment card, you will skip the "Make a Payment/Add a Claim" process and simply print out the Claim Form for that card purchase. Use the Claim Form as a fax cover sheet and fax it along with your receipts to the number shown on the form.
Please remember that credit card receipts, non-itemized cash register receipts and cancelled checks cannot be used to substantiate a claim.
- Reimbursement Claims Processing. We will promptly process your request and reimburse you either by check or direct deposit if you sign up for that feature. Please note that you will receive your money sooner if you use direct deposit.
- Account Management. Log on to your account regularly to check your account balance and access health education tools.
No. One of the main differences between the HRA and the FSA is the funding. HRAs are funded solely through employer contributions while FSAs are typically funded by the employee, usually through pre-tax, payroll deductions. Contact your Human Resources office for information about your plan.
HRA funds are mandated by the IRS to be used for healthcare expenditures only. Approved healthcare expenditures include those expenses identified by your employer as reimbursable from the HRA that are described as Medical Expenses in Section 213(d) of the IRS code. These expenses may include deductibles, coinsurance, copayments, prescription drugs, vision care and dental care. Your employer may limit the expenses your plan reimburses; please consult with your Human Resources office for more information or call The BenefitWallet Service Center.
The IRS has a list of approved healthcare expenditures. Please keep in mind that your employer might have additional limitations. Examples of expenses that are not eligible for reimbursement include:
- Medical expenses that are not defined as eligible under your employer's plan;
- Medical expenses that do not meet IRS section 213(d) requirements (e.g., gym memberships, nutritional supplements, cosmetic procedures and surgeries);
- Medical expenses incurred by you, your spouse or any eligible dependents prior to your effective date in the plan; and,
- Medical expenses that can be reimbursed to you through any other source such as group health insurance.
If you file a manual request for reimbursement of a non-eligible expense, the request will be denied. If you used the healthcare payment card and the expense is deemed ineligible after the expense is already paid, you will be required to reimburse your account for that transaction. If you fail to reimburse the account, you may be required to pay income taxes.
Contributions and tax information
The annual contribution is determined by your employer. Please see your plan documents or consult with your Human Resources office for more information.
An employer may include an account cap or limit on the total balance that you can accumulate in the HRA at any given time. No additional contributions will accrue until the account is used and the balance falls below the cap. Please see your plan documents or consult with your Human Resources office for more information.
An employer may include an HRA rollover maximum which is a limit on the available balance that you can carry over from one year to the next. Please see your plan documents or consult with your Human Resources office for more information.
No information related to an individual HRA is reported to the IRS. Your employer, may be required to file an IRS form 5500 which includes HRA participation and total disbursement information for the plan (Form 5500 does not include individual HRA information).
Health insurance coverage
Yes. The HRA is designed to cover expenses not paid by your health plan including deductibles, coinsurance and copayments as well as many expenses your health plan may not cover.
Using your account
You will receive a healthcare payment card to access your HRA. You can also pay for eligible expenses with any other form of payment and request reimbursement from your account.
You have access to the account when your plan becomes effective. However, you will only be reimbursed for the balance available at the time of your request. Any unpaid amount, up to the annual contribution amount will be paid as additional contributions are credited to the account. Services must be rendered before they are reimbursed.
Account Balance and Claims Status information is available by:
- Logging on to your online account at any time for balance information. Your online account is secure and updated in real time.
- Calling the BenefitWallet IVR at any time for automated account balance information.
- Contacting the BenefitWallet Service Center.
Manual reimbursement requests that exceed your account balance will be reimbursed up to the amount available in the account. You will continue to be reimbursed as additional contributions are made according to the reimbursement schedule set up by your employer.
No. The HRA is an employer provided plan. However, there are valid changes in status associated with your underlying health plan coverage that may affect your HRA participation.
An employer may allow an employee to continue to incur expenses and spend down their account after they leave the company or retire. COBRA coverage must be offered if the employer does not provide this option. At termination of employment, your healthcare payment card will be deactivated. You may still access funds for services incurred before you leave the company and while you were covered under the plan, but your reimbursement request must be made manually. You are not eligible to use the funds for services incurred after your HRA terminates. Some HRAs may be set up to be portable which means you retain ownership of the funds after you leave the company. Please see your company’s plan documents for more information.