Health Reimbursement Arrangement 

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Our Mission: We strive to take care of those people who do so much to take care of our communities—like public school employees, law enforcement and firefighters, and municipal employees—by providing best-in-class administration for the benefit plans that allow them to live with security and to retire with peace of mind.

Our Vision: It’s our vision that MidAmerica will become the nation’s most trusted provider of public sector benefits funding and administration, helping five million employees in their personal health and wellness journey.

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Submitting Claims

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Claims Eligibility + 

Eligible Medical Expenses

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Informational Packets + Sheets

How participating in multiple reimbursement plans may impact expense eligibility.

Click here to view Claims Eligibility + Eligible Expense FAQs.

Need more details? Check out our FAQs.

Need more details? Check out our FAQs.

Click here to view Claim Documentation FAQs.

VISUAL EXAMPLES

What does accepted documentation look like?

The Who, What, When, Where + How Much of Claims Documentation

Itemized Statement

Prescription Receipt

Award Letter

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Using my Benefit Debit Card

The easiest way to pay for your medical expenses.

Paying for eligible medical expenses at the point-of-sale with your debit card is the quickest way to use your benefit funds. In most cases, all you need to do is swipe your debit card and you’re all set. Occasionally, we may notify you that we need additional documentation to complete your claim, so hang on to those receipts just in case!

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Info Sheet

You'll receive two cards in the mail once you become claims eligible.*

Claims eligibility depends on how your employer designed your plan along with your current employment status. Here's a quick view of different HRA types and when you can expect your debit cards:

Integrated (Active) HRA
If your HRA is integrated with your health plan, you have immediate access to your HRA funds and are eligible to submit claims once you receive your first contribution. Once MidAmerica receives the contribution from your employer, two debit cards in your name will be mailed to you.

Defined Contribution HRA
If your HRA is funded while you are actively working for the employer sponsoring the account for use at retirement, you become claims eligible once you retire or separate from your employer. Once MidAmerica receives  your retirement or separation date from your employer, two debit cards in your name will be mailed to you.

Retiree  HRA
If your HRA is funded once you retire or separate from the employer sponsoring the account, you have immediate access to your HRA funds and are eligible to submit claims once you receive your first contribution. Once MidAmerica receives the contribution from your employer, two debit cards in your name will be mailed to you.

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Frequently Asked Questions

What is a Health Reimbursement Arrangement (HRA)?

An HRA is an employer-funded, tax-advantaged health benefit plan that reimburses you for eligible out-of-pocket medical expenses and, in some plan designs, individual health insurance premiums. HRAs allow the employer to make deposits on their employee and/or retiree’s behalf. The employer and employee both save 7.65% in FICA taxes and, depending on plan design, funds carry over year-to-year. Deposits, accumulation, and reimbursements are all tax-free. To learn more about how your HRA is designed, review the Plan Highlights mailed to you with your Welcome Kit. You can also request a copy of your Plan Highlights by calling (855) 329-0095 or emailing [email protected]

Do I have to enroll?

You are automatically enrolled by your employer. No action is necessary on your part.

What are the benefits of an HRA?

  • Employer deposits are tax-free (not subject to FICA, Federal, or State income taxes), so you receive 100% of the
    value of each benefit dollar.
  • Deposits earn interest tax-free. 
  • Reimbursements from the plan are tax-free for eligible medical expenses and premiums for you, your spouse, and any qualifying dependents, if applicable.

How often will my employer contribute to my HRA? 

Contribution frequency may vary depending on the employer group. For detailed information regarding contribution amounts and timing, please contact your employer.

Can I make contributions to my HRA?

Only an employer can fund an HRA. You cannot contribute.

How are my funds invested? 

Investments are provided by American United Life Insurance Company®, a OneAmerica® Company (AUL). To learn more about how your funds were invested and if you have diversification options, review the Plan Highlights mailed to you with your Welcome Kit. You can also request a copy of your Plan Highlights by calling (855) 329-0095 or emailing [email protected]. For more information on your investments and AUL, please visit www.oneamerica.com. You can also download an investment management guide by clicking here. Not sure if your funds are invested? Contact us at (855) 329-0095 or email us at [email protected].

Can I name a beneficiary? 

No. However, a surviving spouse or qualifying dependent will still be able to access funds for eligible medical expenses and premiums. If you do not have a surviving spouse or qualifying dependent, the executor of your estate or trustee can use your remaining funds to reimburse eligible medical expenses and premiums not previously submitted on your behalf, including expenses related to your death. If an account balance still remains after 12 months with no plan activity, the balance will forfeit back to the employer.

Can I move HRA funds to another plan? 

The funds deposited in your account must stay within your employer-sponsored HRA plan.

General

Claims Eligibility + Eligible Medical Expenses

HRA: What is it and how does it work for me?

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Triple tax-free.
Contributions, earnings and reimbursements are never taxed.

Funded by your employer.
HRAs are 100% employer-funded—nothing is taken out of your paycheck to fund the benefit.

HRAs reimburse eligible medical expenses tax-free.
HRAs help you offset health care costs by covering expenses like prescriptions, eyeglasses, doctor's visits, and in some cases, premiums or high-deductible health plans. If you become claims eligible when you retire, the HRA is also a valuable way to bridge the gap between Medicare eligibility and retirement.

Eligible Expenses are determined by IRS.
The Internal Revenue Service (IRS) defines what a qualified medical expense is within Internal Revenue Code Section 213(d). Click here to access the current full listing. 

What's eligible for reimbursement can vary depending on your unique HRA.
Your employer has designed your HRA to uniquely fit the organization’s needs. This means, for example, your HRA could provide reimbursement of all eligible medical expenses in IRC Section 213(d) or allow for the reimbursement of premiums only. It’s important that you review your Plan Highlights to understand what expenses you can be reimbursed for once you become eligible.

Medical expenses incurred before you're claims eligible are not reimbursable.
For example, if you become eligible for HRA reimbursements when you retire or separate from employment, the doctor's visit you had while you were actively working won't be approved for reimbursement. 

Can be used by you, your spouse, and/or an eligible dependent.
You can use your HRA to reimburse your eligible medical expenses or the eligible medical expenses incurred by your spouse and/or eligible dependent.

HRA FAST FACTS

MidAmerica Journey Participant Overview GuideHRA Eligible Expense GuideHRA/FSA/HSA InteractionHow to Submit Claims through MidAmerica JourneyClaims Documentation Informational SheetDebit Card FAQ Sheet

Claims Documentation Requirements

Why does MidAmerica require claims documentation with reimbursement requests?

Like many health care and retirement benefits, the HRA is regulated by the Internal Revenue Service. This means at MidAmerica, we follow these IRS guidelines to make sure your plan is in compliance. When you become claims-eligible and begin submitting reimbursement requests, we may follow up and ask for further documentation to substantiate and approve your claim. This is to make sure your claim is properly adjudicated—protecting your HRA funds and keeping your plan compliant.

What type of documentation should I include with my eligible medical expense reimbursements?

You can substantiate your claim with one of the following: 

  • The Explanation of Benefits (EOB) statement returned to you from the insurance carrier indicating the amount you are responsible for 
  • Copay receipts if you are covered under a managed care or prescription drug plan

If there is no insurance for the health care expenses, submit an itemized bill with the following:  

  • Name of the provider and patient 
  • Service cost, date, and description 
  • Notation when there is no coverage

What type of documentation should I include with my premium reimbursement?

You can substantiate your claim with a Premium Notice, such as a bill or letter from the insurance company, which includes the following: 

  • The premium amount 
  • The effective date of coverage 
  • The type of insurance 
  • Name of the person insured—this will be you, your spouse or a qualifying dependent 

If you are requesting reimbursement of a long-term care premium, you must also provide proof of payment (in addition to the items listed above.)

What type of documentation should I include with my eligible prescription reimbursements?

To substantiate your prescription claim, we must receive documentation that includes all five pieces below: 

  • Patient name  
  • Provider or pharmacy name 
  • Date of prescription 
  • Prescription name 
  • Cost of prescription 

The most common (and accessible) documentation that includes all five identifying details is a prescription summary print-out from your pharmacy. You may also locate this information on the prescription label, which is often stapled to your bag (in addition to being affixed to the prescription itself).

Who is eligible to receive the benefits of my HRA?

You, your spouse, and any qualifying dependents are able to seek reimbursement for eligible medical expenses and,
in some cases, premiums from the HRA. Qualifying dependents include children under the age of 27 at the end of
the tax year and any tax dependents.

How do I know if I’m eligible to submit claims? 

Availability to your HRA funds may vary depending on how your plan is set up. When you log into your account online, you can see which accounts are available to spend from by scrolling down to the Accounts section on your home page. If the account says, Not Available to Spend, it means you have not yet reached the eligibility requirements necessary to access the plan (which is often retirement or separation of service.) To learn more about your plan’s unique eligibility requirements, review the Plan Highlights that was mailed to you with your Welcome Kit. You can also request a copy of your Plan Highlights by calling (855) 329-0095 or emailing
[email protected].

How do I know what expenses are eligible for reimbursement under the plan? 

For a listing of eligible medical expenses, log into your account at www.myMidAmericaJourney.com and select Tools & Support. From here, you can download the HRA Eligible Expense Guide. You can also learn more about your plan’s unique eligible expenses by reviewing the Plan Highlights that was mailed to you with your Welcome Kit. To request a copy of your Plan Highlights, call (855) 329-0095 or email [email protected].

Am I still eligible for a Premium Tax Credit (subsidy) if I have an HRA?

Yes. If you qualify for a Premium Tax Credit under the Affordable Care Act (ACA), you must suspend your HRA to receive the credit. You will not be able to incur expenses for reimbursement during the time your HRA is suspended; however, your employer is still able to contribute to your account during the suspension and your account continues to earn interest. You can submit reimbursement requests for any expenses that were incurred prior to the suspension. The suspension must remain in effect for the duration you are receiving the tax credit. Please log into your secure online account through www.myMidAmericaJourney.com and select Tools & Support to obtain the Account Restriction/Suspension Form.

Can I be reimbursed for medical expenses I haven’t paid yet? 

Yes. You can submit a claim prior to paying the bill as long as you have incurred the expense. The exception to this
would be long-term care premiums.

Can I receive payment for premium expenses I haven’t incurred yet? 

No. Premium expenses must be incurred prior to being reimbursed. You are not able to submit a reimbursement request for an entire year’s worth of premiums in advance. Long-term care premiums cannot be set up for recurring reimbursements due to IRS annual limitations based on the year in which the payment was made. For this reason, proof of payment is required for all long-term care claims.

What does it mean to "incur" an expense?

To incur an expense means that the service has been rendered. Pre-payments of services are not permitted.

Recurring Premium Payment Timeline and Best PracticesContact Us

*Please note if you have a defined contribution Health Reimbursement Arrangement (HRA) and are still actively employed, you will not receive a debit card until you retire or separate from service and become claims eligible. If you have a limited purpose HRA that only allows the reimbursement of deductibles, post-deductible expenses or coinsurance you will not receive debit cards but will have access to the online portal and mobile app to submit claims. Not sure what type of HRA you have? Contact our Participant Services team at [email protected] or (855) 329-0095.

Premium Notice

Letter from your Employer

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