Beginning 10/1/10, HRA plans were required to report on a quarterly basis all covered HRA participants and dependents that meet specific criteria. If Employers self administer their HRA, they are required to abide by this reporting as we
The purpose of reporting is to enable CMS to correctly pay for health insurance benefits of Medicare beneficiaries by determining primary vs. secondary payer responsibility. The employee/dependent data helps to assure that claims will be paid by the appropriate organization at first billing.
Health Reimbursement Accounts (HRA's)
PRO: Employer owns the money shared by the employees. Any balance at the end of the year falls back upon the employer.
PRO: Employees have a substantial percentage of their claims reimbursed by their employer, often pre-deductible and post-deductible.
PRO: An HRA Arrangement is typically the best way to address concerns from those nervous about HDHPs.
MYTH: Most or all claims must be substantiated by the HRA Administrator, a process that can take weeks.
TRUTH: HRA Claims administered by Polestar Benefits are processed within two business days.
MYTH: Because claims are processed by an HRA Administrator, employees must pay bills first with their own money. These costs can be quite high and burdensome to some individuals and families.
TRUTH: We offer "Pay to Provider" option which allows employees to submit their reimbursement requests and the money is paid directly to the Provider, without being a burden on the employees pocket.
Flexible Spending Accounts (FSA's)
PRO: Pre-tax contributions.
PRO: Employees have total control over how they spend their money; so long as it is a health care or dependent care related expense (depending on which type of account is opened).
PRO: Can use an FSA with all types of health care plans, not only high deductible plans.
PRO: Can be used for "optional" medical procedures not covered by insurance, such as LASIK eye surgery, non-elective cosmetic surgery, braces, etc.
PRO: Can be used for child care or dependent care (with a Dependent Care Account)
CON: Use it or lose it.