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Deductible Gap HRA Plan Design Notes – Best Design of the Week

Every employer should establish a Section 125 Cafeteria and;or HRA plan in a post ACA health insurance world.

Gene C. Ennis – April 20, 2015 – Bradenton, FL –

Another HRA Plan Design Award of the Week

I see a lot of HRA Plan designs come across my desk. The Agent who submitted the HRA Plan design notes below is a pleasure to do business with. She gets it, and knows how to give us all the details we need as succinctly as possible.

The following Deductible Gap HRA plan design notes is an example of information we need to address every benefit option the Agent and Employer designed into their Plan. This is from an Insurance Agent who has ordered hundreds of HRA Plans and consistently gives us everything we need to produce their documents quickly and efficiently.

Note Area of the online Core HRA Application recently completed by a competent Insurance Agent:

The underlying medical plan is not HSA compatible. The HRA will reimburse for in network claims. both the HRA and the Medical plan run on a plan year. The annual deductible is $3000/$6000. The HRA will reimburse the last portion of the deductible. An individual is responsible for the first $2000 of deductible charges, and then the HRA pays the last $1,000. A family is responsible for the first $4,000 of deductible expenses and then the HRA pays the remaining $2000. Embedded. HRA DEDUCTIBLE MAX is $1000/$2000. The plan will also reimburse for copays as follows: INPAT HOSP $500/ OUTPAT SURG/$750 IMAGING $450/ ER $400. WILL PAY UNLIMITED COPAYS. there is no carryover of unused funds. Run out on claims submissions is 90 days.

See Blog Post 06/23/2016:  Small Business Healthcare Relief Act H.R. 5447 Would Create Safe-Harbor for Non-Exchange Individual Health Insurance Premium HRA Plans

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Core Documents, Inc. has been providing free consulting, affordable plan documents, and plan updates as needed for Section 125 Cafeteria Plans and Health Reimbursement Arrangements since 1997. See more information about these fringe benefit plans at Core Documents’ website: www.coredocuments.com, or call toll free 1-888-755-3373.

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