HRA Product Offerings

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1 HRA Product Offerings

2 HRA Plan Designs Standard 213(d) HSA Compatible (Limited) Deductible Only RX Only including OTC Percentage Payment All Medical and RX All Medical and RX Employee Pays First Deductible Only Employee Pays First

3 HRA Plan Conditions Employees enrolled in a HRA plan should only be enrolled in one HRA plan offered by your company. A debit card is not an available reimbursement option when two or more Health Reimbursement Arrangement (HRA) plans are offered with different eligible expenses. Participants will not receive a debit card for the FSA and/or HRA plans. Employees enrolled in your company s HRA with Spouse and/or Family must have dependents setup upon enrollment in the

4 Standard 213(d) HRA ER Contribution applied upfront to be used by any one family member or combination of members. Funds can be used only for eligible expenses defined as (213(d), including Medical, Dental, Vision, Pharmacy, OTC. Payment features under this option include Pay Me Back, Pay By Card, and Pay My Provider. Please note, if FSA is offered, the debit card may also apply on the FSA.

5 HSA Compatible (Limited) ER Contribution applied upfront to be used by any one family member or combination of members. Funds can be used only for eligible Dental and Vision expenses. Post Deductible change to 213(d), including Medical, Dental, Vision and Pharmacy. Payment features under this option include Pay Me Back, Pay By Card, and Pay My Provider. Please note, if FSA is offered, the debit card may also apply on the FSA.

6 Deductible Only ER Contribution applied upfront to be used by any one family member or combination of members. In Network Medical Deductible Expenses are included, Client may opt to also include Out of Network Medical Deductible Expenses. Payment features include Pay Me Back and Pay My Provider. Debit Card does not apply with this HRA Option. Please note, if FSA is also offered, the debit card will not be available.

7 RX Only including OTC ER Contribution applied to participant accounts one time ER Contribution applied upfront to be used by any one family member or combination of members. Funds can be used only for eligible Pharmacy expenses, including OTC. Payment feature under this option only include Pay Me Back. Debit Card does not apply with this HRA Option. Please note, if FSA is also offered, the debit card will not be available.

8 Percentage Payment ER Contribution applied upfront to be used by any one family member or combination of members. Funds can be used only for eligible expenses defined as (213(d). A percentage of each eligible Medical, Dental, Vision, Pharmacy claims submitted will be reimbursed. Payment features under this option include Pay Me Back and Pay My Provider. Please note, if FSA is also offered, the debit card will not be available.

9 All Medical and RX ER Contribution applied upfront to be used by any one family member or combination of members. Funds can be used only for Medical expenses, including all Medical expenses such as Medical Deductible, Copays, Coinsurance, and Out of Network. Prescription expenses, including all RX such as RX Deductible, RX Copays, OTC items. Payment features under this option include Pay Me Back, Pay By Card, and Pay My Provider. Please note, if FSA is offered, the debit card may also apply on the FSA.

10 All Medical and RX Employee Pays First Employees and dependents will be responsible to pay the first portion of eligible expenses before HRA funds become available. Entire family responsibility must be met before any HRA funds are available for any family member. Funds can be used only for Medical expenses, including all Medical expenses such as Medical Deductible, Copays, Coinsurance and Out of Network. Prescription expenses, including all RX such as RX Deductible, RX Copays, OTC items. Payment features under this option include Pay Me Back, Pay By Card, and Pay My Provider. Please note, if FSA is offered, the debit card may also apply on the FSA.

11 Deductible Only Employee Pays First Employees and dependents will be responsible to pay the first portion of eligible expenses before HRA funds become available. Entire family responsibility must be met before any HRA funds are available for any family member. In Network Medical Deductible Expenses are included, Client may opt to also include Out of Network Medical Deductible Expenses. Must provide all eligible dependent information during enrollment in the Payment features include Pay Me Back and Pay My Provider. Debit Card does not apply with this HRA Option. Please note, if FSA is offered, the debit card also does not apply on the FSA.