Unified Fire Authority
Health Reimbursement Arrangement ( HRA )
The HRA Plan has been established to help you pay for the out-of-pocket costs that are associated with the UFA group health insurance deductible .
1 . Individual Deductible is $ 1,000 » Individual is responsible for the first $ 500 of their deductible . Anything spent over $ 500 will be automatically reimbursed to the employee .
2 . Family Deductible is $ 2,000 » Family deductible can be satisfied by two ( 2 ) individual deductibles being met or by multiple family members contributing to and satisfying the $ 2,000 deductible
* Note you will have to submit a manual claim for reimbursement for all out-of-network claims .
How do I get reimbursed ? The HRA Plan will be administered by a third party provider APA Benefits , Inc . APA Benefits will work directly with SelectHealth when it comes to getting you reimbursed . You will no longer need to submit a claim form and an EOB form for reimbursement unless you go out of network to have services rendered . Your claim will be automatically paid via check or direct deposit after SelectHealth has entered the claim and sent the claim details to APA Benefits , Inc . APA Benefits will process these claims and payments weekly .
If you go out-of-network please follow these steps to be reimbursed :
1 . Submit a copy of the most recent EOB ( explanation of benefits ) and a HRA claim form to APA Benefits , Inc . ( This can be done online ). We can ’ t process your claim without the EOB .
2 . You should receive your reimbursement via check or direct deposit within 1-2 business days after adjudication of the claim .
What can I be reimbursed for ? 1 . Individual deductibles over $ 500 or family deductibles over $ 1,000 2 . You shouldn ’ t use your FLEX card if you are going to be reimbursed by the HRA
3 . You will not be reimbursed for copayments such as primary care , specialist , emergency room ( ER ) or prescription . Only services that are included in the deductible can be reimbursed through the HRA program .
Scenario John Doe goes in for a routine surgery at the hospital . When he receives his EOB from Select Health it states that he has $ 835 in services that are included in his deductible . APA Benefits , Inc . will cut either a check or send an ACH to him automatically for $ 335 . ( If the services were provided by an out of network provider , he will need to submit the HRA claim form and EOB to APA Benefits , Inc . He then receives a check or ACH from APA in the amount of $ 335 ). Once he receives the bill from the provider he can pay for the first $ 500 of the deducible with his Flexible Spending Account money ( If John Doe didn ’ t sign up for the FLEX account he must pay for the charges out of pocket ) then he can pay the remaining $ 335 with the reimbursement he received from APA Benefits , Inc . He is still eligible to receive up to an additional $ 165 of reimbursement this plan year , if he has any additional expenses that are included in the deductible .
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