A Health Reimbursement Account (HRA) is an account funded by the College in the amount of $375 in calendar year 2015 to assist you with eligible expenses associated with the Bowdoin College PPO Health Plan.
Who is eligible?
Benefits eligible employees earning less than $43,001, who are covered by the Bowdoin College PPO Health Plan, are eligible. You can use this benefit for yourself and/or any family member covered by the health plan. Eligible employees are automatically enrolled, but you may decline participation by contacting Human Resources at X3837.
How do I use my HRA?
EBPA, the College’s HRA carrier, will issue one HRA debit card to each eligible employee when you first become eligible. The card is valid through the expiration date listed on the card as long as you continue to be enrolled in the PPO health plan and your earnings are less than $43,001. You may use your HRA benefit for out-of-pocket expenses associated with the PPO health plan. The HRA benefit cannot be used for costs that are not covered by this health plan, such as band-aids, over-the-counter medications, eye glasses, contact lenses, dental procedures, etc. Here are the guidelines for using your HRA card:
- Swipe your Card for doctor office visit and/or prescription drug copayments. In 2015 office visit copayments are $20 for a primary care visit and $40 for a specialist visit. Prescription drug copayments are $10, $40 and $60 and mail order prescription drug copayments are $20, $80 and $120. Swipe your card only when the office visit or prescription drug copayment is for an exact amount listed above. Any other amounts require substantiation and must be submitted to EBPA using a paper claim form along with a receipt from the provider explaining the charge.
- Submit a Paper Claim Form to EBPA with receipts for services that must be submitted through the PPO health plan first and for a copayment other than the amounts listed above that will require substantiation. An Explanation of Benefit form from Anthem is the best receipt. The PPO health plan has an annual deductible of $500 per individual/$1,000 per family and then claims are paid at 90% in-network (preferred in-network deductible is $100 per individual/$200 per family). Amounts that you incur towards the deductible and 10% in coinsurance are eligible for reimbursement through your HRA benefit up to $375 per calendar year.
Failure to follow the above guidelines may result in temporary deactivation of your HRA card. Once you have provided appropriate documentation to EBPA, your claim will be processed and your card reactivated.
How often does EBPA review claims and send reimbursement funds?
EBPA reviews claims and sends reimbursement on a biweekly basis. You may obtain information on the status of claims or your available balance by calling EBPA at 800-578-3272.
What if I lose or misplace my debit card?
Contact Human Resources at X3837 to request a replacement card.
What happens if I leave College employment?
If an employee decides to leave the College, the HRA is discontinued as of the 1st of the month following the termination of employment. The employee will have 30 days to submit a claim for services incurred prior to the termination of employment. An employee electing COBRA continuation coverage for the Bowdoin College PPO Health Plan may also elect continuation coverage for the HRA.
Does the HRA amount carry over from year to year?
Employees have until March 31st after the conclusion of the plan year (the calendar year) to submit claims that were incurred during the prior plan year. If you do not use the entire $375 funded in your HRA, it does not carry forward to the next calendar year.
What if I want to have a Medical Flexible Spending Account (FSA) in addition to my HRA?
In general, for claims associated with the PPO health insurance plan, use your HRA first. Some medical claims that are not associated with the health plan (e.g., purchase of new eye glasses, contact lenses, dental claims, etc.) are not eligible for reimbursement through your HRA and must be submitted through your FSA if elected. You may not use the same receipt two times – submit it to the HRA and then also submit it for reimbursement through your FSA.
Mail or Fax Claims to:
EBPA Reimbursement Accounts (HRA)
P. O. Box 1140
Exeter, NH 03833-1140
Bowdoin College HRA – Summary Plan Description
First Amendment to Out-of-Pocket Expenses Reimbursement Plan - 2014
HRA Claim Form