EBC HRASM

The EBC HRA^SM Self Administration fills in the gaps left by health insurance plans by covering participants’ eligible, uninsured health insurance expenses. Fully customizable to meet employers’ needs, the plan is an ideal complement to a high-deductible health plan and a way to give participants control over and awareness of their health care spending. As a self-administered plan, we provide compliant and efficient administration materials, and the employer handles the day-to-day plan administration.
The EBC HRA^SM allows participants to draw upon employer-funded accounts for reimbursement of their qualified, eligible expenses. When EBC HRA participants swipe the Benny^TM Benefits Card to pay for an eligible expense, it automatically debits the connected EBC HRA account. This saves participants from having to pay with out-of-pocket cash and manually submit a claim for reimbursement.
The Benny^TM Benefits Card works with specific EBC HRA plan designs. Our Sales team can assist employers in determining whether the card will work under their existing EBC HRA plan design or help employers choose an EBC HRA plan design that will work with the Benny^TM Benefits Card.
We offer the Benny^TM Benefits Card with the following plan designs:

• An EBC HRA that reimburses all Section 213 expenses
• An EBC hra that reimburses medical deductible, coinsurance, and co-pay expenses only
• An EBC HRA that reimburses prescription and over-the-counter expenses (under this plan, the card can be used at any retailer that has an IIAS or that earns 90 percent or more of its revenues from the sale of eligible healthcare items)
• An EBC HRA that reimburses prescription expenses, but not all over-the-counter health care items (in this case, the card should only be used at retailers that can distinguish between over-the-counter items and prescriptions)

If there are more than two tiers in the plan design or the employee is required to pay first or a percentage, the Benny^TM Benefits Card is not an available option. Also, if Employee Benefits Corporation receives electronic claims information from the employer’s insurance carrier, Benny^TM is not a necessary convenience.

How the EBC HRA works

The EBC HRA works in many ways but it is most commonly used to fill the gaps in coverage that high-deductible health plans leave.
Take this as an example.
Sally is a mother and wife who, from time to time, has to take herself and her other family members to the doctor for check-ups, tests and medicine.
She’s also an EBC HRA participant who must meet a $4,000 family deductible before her employer’s underlying high-deductible health plan begins covering her and her family’s medical expenses in full.
Since $4,000 is a steep deductible, the EBC HRA fills the gap it leaves – the plan reimburses Sally for her family’s first $2,000 of eligible, deductible-related medical expenses. After she visits the doctor, she receives from her insurance provider an Explanation of Benefits (EOB), which she submits with an EBC HRA Reimbursement Form to Employee Benefits Corporation for reimbursement. We process the claim and mail or directly deposit her reimbursement, and she uses it to pay the medical provider’s bill.
Once she accumulates $2,000 in eligible expenses, her family covers the next $2,000 in medical expenses. She continues to submit her eligible expenses and, if she reaches the $4,000 deductible, the health insurance takes over.

How participants get reimbursed from the EBC HRA

When participants go to the doctor, they can use the EBC HRA to pay for all or a part of their qualified, eligible expenses by taking the following steps.

1. Present the insurance carrier card to the health care provider
2. The health care provider submits the expense to the insurance carrier
3. The insurance carrier reviews the expense, negotiates charges, awards discounts and creates an Explanation of Benefits (EOB) which is sent to the participant and their health care provider
Standard reimbursement:
4. Complete an EBC HRA Reimbursement Form and fax or mail it to Employee Benefits Corporation with a copy of the EOB attached Automatic reimbursement:
   
5. The insurance carrier automatically submits the expense to Employee Benefits Corporation, and we use that information to process the claim

We then review the claim and, if it is for a qualified eligible expense under the employer’s EBC HRA plan design, we directly deposit or mail a reimbursement check. The participant uses the reimbursement to pay their medical bill.
Qualified, eligible expenses that are not considered deductible or coinsurance expenses may not require submission to the participant’s insurance carrier; however, they must submit an EBC HRA Reimbursement Form with a copy of the receipt or bill showing the date, cost, type of service and provider name.