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? 3. Individual deductibles over $ 500 or family deductibles over $ 1,000 4. You shouldn’ t use your FLEX card if you are going to be reimbursed by the HRA
5. 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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