Reclaiming the Power of Health

Health Reimbursement Arrangement (HRA)

Customized & Helpful

The NueSynergy Health Reimbursement Arrangement (HRA) is an employer funded tax-advantaged account that can be designed to the specific needs of an employer and their employees. NueSynergy will work with employers and their agent or consultant to implement the HRA plan that helps the employer both manage their overall health care costs while providing employees with a benefit that assists them in paying their out-of-pocket medical expenses.

Each plan year, the employer will determine how much money to contribute to the HRA, set the threshold for when funds are available, as well as what expenses will be considered eligible for reimbursement. For example, an HRA could pay all eligible medical expenses, including deductible and co-insurance expenses, or the HRA could be limited to cover only dental or vision expenses.

Once eligible expenses are incurred the employee can access their HRA funds by:

• Submitting an eClaims reimbursement through NueSynergy’s carrier integration module

• Submitting an online claim through the NueSynergy Member Portal

• Submitting a paper claim via fax or mail

• Using the NueSynergy Benefits debit card (based on plan design)

What HRAs Can Do For You

We make sure everybody wins.

  • HRA contributions are not considered part of an employee’s income. Therefore, any funds used by the employee are not subject to income, FICA or worker’s compensation tax; however, they are tax deductible to the employer.
  • HRA funds do not have to be distributed until an expense is incurred.
  • Employers determine what expenses are eligible. (i.e. deductible, co-insurance, Rx)
  • Employers maintain the amount of funds to make available and when.

HRAs Done Your Way

Customize to your unique needs with our Premium Reimbursement HRA Plan.

For employers with less than fifty (50) full-time employees: instead of offering a group insurance plan, they can allow employees to shop for an individual health insurance plan that best fits their unique needs while also helping employees to cover their monthly premium cost through an HRA.
Employers are able to provide reimbursement through the HRA up to $4,950 for individual plans and $10,000 for family plans per year.

As with all HRA contributions, they are not subject to an employee’s income, FICA or worker’s compensation tax; however, they are tax deductible to the employer.

NueSynergy will work with the employer to manage the premium payment process, including facilitation of payment for any portion of the premium the employee may be responsible for that the HRA does not cover.

Health Reimbursement Arrangement

Who Is Eligible

General Eligibility – Typically all benefit eligible employees can participate in an HRA.

Plan Eligibility – Employers can also set additional eligibility rules for the HRA plan such as:

  • Limiting eligibility to a particular health plan as long as they do not discriminate in favor of highly compensated employees.
  • Cover only employees or cover employees and their dependents, as well as domestic partners as long as they meet the IRS Section 152 definitions.
  • Provide coverage to retirees.

(Note: Partners in a business, members of LLCs, and shareholders who own 2% or more in S-corporations, however, are not eligible to participate in the HRA.)

Contribution Limits
Funding Limits - There is no limit on the amount of money your employer can contribute to the HRA. Each year your employer may set the HRA limits based on the overall strategy and goals of the group health plan. Additionally, based on plan design, the maximum reimbursement amount credited under the HRA each year could be increased or decreased by amounts not used during a previous plan year.

  • HRAs are funded solely by the employer.
  • Contributions are not included in the employee's income.
  • No federal income taxes or employment taxes on amounts your employer contributes to the HRA.

Plan Designs

The Health Reimbursement Arrangement provides employers with enormous flexibility when determining the plan design that best fits their needs and budget. Below are just a few examples of plans designs an employer could implement for their group.

HRA Type HRA Description HRA Example
Employee Pay First The employee pays their employer-defined portion of the out-of-pocket expenses. Once met, the employer funded HRA is activated and used to pay the remaining portion of the health plan deductible.  

Employee: $400 | HRA: $800

Employer Pay First The employer funded HRA is used to pay the first portion of the health plan deductible, then the employee pays the remaining balance of deductible expenses. HRA: $200 | Employee: $600
Employer GAP HRA The HRA employer pays the first portion of deductible expenses up to a limit defined by the plan. Next, the employee pays the remaining portion of the deductible expenses. The HRA employer is reactivated to reimburse a defined amount of co-insurance expenses after which the employee is responsible for the remaining portion of their co-insurance up to the out-of-pocket maximum. Employee: $400 | HRA: $800 | Employee: $400 
Employee Gap HRA The employee pays the first portion of deductible expenses up to a limit defined by the plan. Next, the HRA employer pays the remaining portion of the deductible expenses. The employee is then responsible for a defined amount of their co-insurance expenses before the HRA is reactivated and can be used to reimburse the remaining portion of their co-insurance up to the out-of-pocket maximum. HRA: $400 | Employee: $800 | HRA: $400 
Percentage Based Reimbursement The employer HRA reimburses the employee a percentage of their out-of-pocket deductible costs up to the employer defined HRA maximum amount. Employee: $500 | HRA (75%) Employee (25%): $1,000 
Co-Pay Share The employer can set a specific dollar amount to reimburse for certain co-pays. Dr. Office: $25 | RX: $50 | ER Visit: $75 
Premium Reimbursement Employers with less than fifty (50) full time employees are able to provide reimbursement through the HRA up to $4,950 for individual plans and $10,000 for family plans per year to help their employees purchase individual health insurance plans that best fits their unique needs.

HRA (Individual) $4,950 | Employee (Individual): $1,050

Total Premium: $6,000

HRA (Family): $10,000 | Employee (Family): $2,000

Total Premium: $12,000

 

 

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