HEALTH REIMBURSEMENT ARRANGEMENT (HRA) CITY OF BOWLING GREEN PLAN YEAR 2018

WHAT IS AN HRA? The Health Reimbursement Arrangement (HRA) is an account funded by the City of Bowling Green to reimburse eligible medical expenses. No funds are withheld from the employee’s paycheck for the HRA. Employees electing medical insurance with the City will have an HRA. The account can be used to reimburse medical expenses. Any unused amounts will rollover to the next plan year. The account maximum for single is $7800 and family is $13,100.

WHAT EXPENSES ARE REIMBURSABLE? ELIGIBLE NON-ELIGIBLE Eligible expenses are Qualified Medical Services that are applied to your in-network deductible and co- insurance with the exception of office visits and co-pays. Office Visits ER Co-pay Pharmacy Co-pay Vision expenses Dental expenses Claims filed for FSA reimbursement

HOW DO I SUBMIT FOR REIMBURSMENT? Complete the Reimbursement Request Form and attach the Meritain Explanation of Benefits (EOB). This form can be mailed, faxed, or uploaded to Meritain’s website at www.meritain.com . HRA claims must be submitted within 12 months of the service date.  Any claims with service dates greater than one year will be denied.

HOW MUCH MONEY DO I HAVE IN MY HRA? Employees electing Employee Only coverage will receive $1000 in their account on January 1 of each year Employees electing Employee + One or Employee + Family will receive $2000 in their account on January 1 of each year. Employees can check their HRA balance on the Meritain website. Rollover funds will show in employee accounts in April due to the run-out period for previous year claims.

ADDITIONAL HRA MONEY Employees and spouses on the health plan can earn an additional $300 in HRA dollars by completing a Health Risk Assessment and reviewing with a provider. The Health Risk Assessment and review with the provider must be completed October 1 – March 31 each year to receive the additional money. Spouses covered as secondary on the City’s plan are eligible for the additional HRA dollars

ADDITIONAL HRA MONEY Assessments completed prior to December 31; HRA dollars will be deposited in January Assessments completed after December 31; HRA dollars will be added in April An Outside Primary Care Provider (PCP) form is available on the CLICK for members not utilizing the City Care Center. Members utilizing the City Care Center do not need to provide a form.

HRA - RETIREES If an employee retires from the City of Bowling Green, amount remaining in the HRA can be used to reimburse any Section 213 eligible expenses. The amount in the account will remain in the account until it is exhausted. There will not be any additional contributions once the employee retires. The claim form for current and retired employees is on the City’s intranet (The CLICK) or can be obtained from the City’s Human Resources Department.

HRA RECAP The HRA is funded by the City of Bowling Green. No funds are withheld from the employee’s paycheck for the HRA. Eligible claims are qualified medical expenses (member responsibility) under the Medical Plan with the exception of office visits, and co-pays. Claims not eligible for reimbursement would include but not limited to dental, vision, prescription, office visit claims and emergency room co-pay. HRA claims must be submitted on a paper claim form either by mail, by uploading to Meritian’s website, or by fax.

HRA RECAP HRA claims must be submitted within 12 months of the service date.  Any claims with service dates greater than one year will be denied. The member CANNOT file a claim under the HRA and the FSA (Flexible Spending Account). The member selects which account to file the claim. If a member retires under the state retirement plan the HRA will remain available for the member to utilize (if money available in the member’s account).  No money will be contributed by the City after the date of retirement.