Health Reimbursement Arrangements (HRA)

A Health Reimbursement Arrangement (HRA) is an employer-funded benefit plan that is fully customizable which gives your clients the flexibility to set which expenses will be eligible under the plan.

HRAs are a great enhancement to your client’s benefit package.  This type of plan gives them the freedom to tailor their company’s benefit options to fit their financial goals, while still offering their employees the best healthcare benefits possible.

We understand that each employer has different needs regarding their benefit plan options, which is why ASi offers a variety of HRA plans.

How an HRA Works

HRAs allow your clients to help offset their employees’ out-of-pocket healthcare expenses.  An HRA is not a stand-alone health insurance plan.  Instead, it is an account that your client funds which offers the client’s employees an allowance of tax-free money.  When their employees incur eligible healthcare (medical, pharmacy, dental, and vision) related expenses, they can submit a claim to ASi or swipe their ASi Visa® Card* (if your client chooses to provide), which allows the HRA to reimburse them up to their individual funding amount.

Self-employed individuals (e.g., sole proprietors, partners, and more-than-2% Subchapter S corporation shareholders) may not participate in an HRA on a tax-favored basis.

ASi offers four different HRA plans to provide the best option to meet your client’s needs.

HRA Plan Designs

An Integrated HRA, sometimes referred to as a Medical Expense Reimbursement Plan (MERP) or Section 105 plan, accompanies a group health plan, which is usually a High Deductible Health Plan (HDHP).  With an Integrated HRA, the client designs a “secondary” benefit plan where employers and their employees have a cost of sharing arrangement.  Your clients have the freedom to tailor the breakdown of benefits, how much they wish to fund, and how much the employee funds of the carrier deductible, coinsurance, or copayments.

Contributions to an Integrated HRA are funded by the employer only.  Employees are not allowed to make contributions to an Integrated HRA. However, MERP designs allow employees to make contributions to the plan. If your client would like to design a plan where employees can make contributions, please contact us about MERPs.

With an Integrated HRA, your client has the option of allowing the following additions:

EOB Retrieve

EOB Retrieve (Explanation of Benefits Retrieve) is a voluntary program that allows the employee’s primary carrier EOBs to be pulled from their primary carrier member portal directly to ASi.  If the employees wish to use this service, they must choose to register. By registering for this service, the majority of their claims will automatically be pulled by ASi for processing.  However, some carriers do not provide EOBs on their member portal and/or some claims may not be accessible to ASi due to carrier restrictions.  It will be the participant’s responsibility to monitor their claims and contact ASi if they suspect a claim as not been paid.

If employees do not elect to register for our EOB Retrieve service, they will be responsible for ensuring ASi receives their primary carrier’s EOBs to us for claim processing.

Integrated Prescription Management (IPM)

IPM is a pharmacy benefit manager that allows participants to pay their pharmacy copays at the point of service.  Without IPM, participants would have to pay out-of-pocket for their prescriptions and then submit a claim for reimbursement to ASi.  IPM also offers a 24/7 pharmacy hotline for any prescription billing issues the pharmacy may encounter.

An Excepted Benefits HRA is a “lump sum allowance” that accompanies a group health plan.  Usually that group health plan is a High Deductible Health Plan (HDHP), but it can be tied to any group health plan your client provides to their employees.  Contributions to an Excepted Benefits HRA are funded by the employer only.  Employees are not allowed to make contributions to an Excepted Benefits HRA. With an Excepted Benefits HRA, employees can use their funding allowance towards eligible out-of-pocket healthcare deductibles and co-pay expenses.  This plan has several additional options to make it more customizable toward your client’s needs.

ASi Visa Card
  • Your client may choose to offer their employees an ASi Visa® debit card which is the easiest option for employees to access their HRA benefits. With the ASi Visa® Card, participants will be able to pay for their eligible healthcare expenses by swiping this card.  They would use this card instead of paying out-of-pocket from their personal banking account.
Benefit Rollover
  • The Rollover option allows unused funds in the participant’s HRA account to be credited to the next plan year’s HRA account. If your client decides to not use this option, any remaining funds in the account remain with the employer.
Bill Back – A Cost of Sharing Option
  • The Bill Back option allows your client to provide first dollar benefits to their employees to use for their healthcare expenses, while also having the employee be responsible for a share of cost. We can bill the employee a predetermined percentage, set by the employer, of their utilized funds.
  • For Example – With Bill Back, the employer could set a 20% cost of sharing expense for their employees. That means an employee could pay up front with their ASi Visa® Card for their eligible healthcare expenses to their provider.  In this case, they spent $250 at their provider’s office.  We would then bill them your client’s predetermined percentage of 20% of their total $250 bill.  This means they would owe $50 for their share.  The employee would then pay their share of cost of $50 to ASi.  ASi would then distribute that money to your client.  The employer would be responsible for the remaining $200.

*ASi will send a monthly invoice for any employee’s share of cost incurred that month. However, it is ultimately the employer’s responsibility to collect the employee’s share of cost amount.  ASi can send reminders to employees about their share of cost bill if requested.

An Open HRA is a “lump sum allowance” that allows your client’s employees a “first-dollar benefit”. Contributions to an Open HRA are funded by the employer only.  Employees are not allowed to make contributions to an Open HRA. A first dollar benefit covers healthcare expenses from the first expense charged up to the total funding balance in the employee’s HRA account.   It does not accompany your client’s group healthcare plan; however, employees must be enrolled in a group sponsored healthcare plan of some sort (I.E. their spouse or parent’s plan).  With an Open HRA, employees can use their HRA allowance to purchase eligible healthcare expenses, out-of-pocket deductibles, and/or co-pay amounts.  This plan has several additional options to make it more customizable toward your client’s needs.

ASi Visa® Card
  • Your client may choose to offer their employees an ASi Visa® debit card, which is the easiest option for employees to access their HRA benefits. With the ASi Visa® Card, employees will be able to pay for their eligible healthcare expenses by swiping this card.  They would use this card instead of paying out-of-pocket from their personal banking account.
Benefit Rollover
  • The Rollover option allows unused funds in the participant’s HRA account to be credited to the next plan year’s HRA account. If your client decides to not use this option, any remaining funds in the account remain with the employer.
Bill Back – A Share of Cost Option
  • The Bill Back option allows your client to provide first dollar benefits to their employees to use for their healthcare expenses, while also having the employee be responsible for a share of cost. We can bill the employee a predetermined percentage, set by the employer, of their utilized funds.
  • For Example – With Bill Back, the employer could set a 20% cost of sharing expense for your employees. That means an employee could pay up front with their ASi Visa® Card for their eligible healthcare expenses to their provider.  In this case, they spent $250 at their provider’s office.  We would then bill them the employer’s predetermined percentage of 20% of their total $250 bill.  This means they would owe $50 for their share.  The employee would then pay their share of cost of $50 to ASi.  ASi would then distribute that money to you.  Your client would be responsible for the remaining $200.

*ASi will send a monthly invoice for any employee’s share of cost incurred that month.  However, it is ultimately the employer’s responsibility to collect the employee’s share of cost amount.  ASi can send reminders to employees about their share of cost bill if requested.

An Individual Coverage Health Reimbursement Arrangement (ICHRA) accompanies an employee’s individual healthcare or Medicare plan.  An ICHRA is a “lump sum allowance” that allows your client’s employees reimbursements for their healthcare expenses, including insurance premiums.  Contributions to an ICHRA are funded by your client, the employer.  Employees are not allowed to make contributions to an ICHRA. It does not accompany your client’s group healthcare plan; however, employees must be enrolled in their own individual healthcare plan or a Medicare plan.  If employees are no longer coverage on their individual healthcare plan, they cannot receive ICHRA reimbursements.  With an ICHRA, your client’s employees can use their HRA allowance to purchase eligible healthcare premiums, expenses, out-of-pocket deductibles, and/or co-pay amounts.

What Expenses Are Eligible?

Eligible expenses are determined by the employer in compliance with the IRS regulations. HRAs are customizable plans and your client is able to tailor them to their specific needs.

For Excepted Benefit HRAs and Integrated HRAs, most employers choose to follow their group health plan’s allowances. However, your client can choose to design their HRA benefit plan however they would like.

We are happy to help you and your client design the best HRA plan for their benefit package. Please contact our Sales or Client Services department for guidance.

Email: salesteam@asibenefits.com or clientservices@asibenefits.com
Phone:  559-256-1320 or 866-777-1320

Employer Features

Your clients become part of the ASi family, which means providing them with the best features within the industry.  The features listed below are included as part of our administrative services.

  • Cost Savings
  • Customizable Benefit Plans and Materials
  • Plans comparable or equivalent to traditional benefit plans
  • Illustrate Cost Comparison of HRA Approach v. Traditional Fully Insured Plan
  • Online and Mobile App Account Access
  • Dedicated ASi Teams Who Provide Personalized Customer Service
  • Assist in Plan Design, Including Plan Design Options and Features
  • Draft Plan Documents, Including the Basic Plan Document, Adoption Agreement, and Summary Plan Description
  • Assist in Group Open Enrollment
  • Provide Participant ID Cards (if applicable) and Plan Materials
  • Claims Reporting
  • Marketing Materials for Your Client’s Employees
  • Timely Claims Processing
  • Provide Standard Reports Upon Request
  • Provide Annual Plan Review
  • Troubleshoot Claims

Participant Features

We know your client’s employees are the heart of their business, which means we provide them with great tools and resources to help them manage their benefits.

  • Online Employee Portal
  • Mobile App
  • Online and Mobile Claim Submission
  • EOB Retrieve (Integrated HRA Only)
  • ASi Visa® Card (Open HRA or Excepted Benefits HRA Only)
  • Easy to Understand Benefits Breakdown
  • Dedicated ASi Teams Who Provide Personalized Customer Service

Want to Know More About this Service?

Check out our FAQs or contact our Sales Team

Phone: 866-777-1320 or 559-256-1320
Email: salesteam@asibenefits.com