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Health Reimbursement Arrangement (HRA)
For Medicare Retirees Enrolled in Medical Coverage through the One Exchange

Summary Plan Description for HRA for Medicare Exchange Retirees

One Exchange HRA Claim Form

What is a Health Reimbursement Arrangement (HRA)?

The Health Reimbursement Arrangement or HRA is a tax-exempt account that retirees enrolled in a plan through the One Exchange can use to pay premiums for medical, dental, prescription drug and vision plans as well as for reimbursement of qualifying health care expenses such as copayments and deductibles.

Here's how it works:

One Exchange HRA Reimbursements for Qualifying Health Care Expenses
1. You pay premiums and expenses

You pay the full premiums directly to your insurance provider (ask the One Exchange Benefit Advisor about the auto-reimbursement option for premiums). You also pay your provider any required out-of-pocket expenses.
2. You submit out-of-pocket expenses

You submit your claim to the One Exchange for your premiums and out-of-pocket health care expenses.
3.One Exchange Reimburses you

The One Exchange administers your account and will reimburse you from your HRA if funds are available.

Exchange HRA Contribution

Medicare retirees receive a contribution to their Exchange HRA based upon their years of service. The monthly tax-exempt contribution amount is $11 per month per year of service beginning with a minimum of five years ($55) to a maximum of twenty years of service ($220). Individuals who retired before January 1, 1994 will receive a flat $165 per month to the Exchange HRA. Dependents and survivors selecting a plan through the One Exchange are not eligible for an Exchange HRA. Medicare retirees can use their Exchange HRA to pay for the premiums or out-of-pocket expenses incurred by their Medicare eligible dependent who also selects a plan through the One Exchange.

HRA Contribution
for Retirees Enrolled in a Medical Plan Through the One Exchange

  • Participants who retired before January 1, 1994, receive15-year ($165) base contribution.

  • Participants who retired on or after January 1, 1994, the contribution is $11 per month, per year of service beginning with a minimum of 5 years or $55 to a maximum of 20 years or $220.

  • Spouses/domestic partners and surviving spouses/domestic partners enrolled in the exchange are not eligible for an Exchange HRA contribution.

  • Retirees on the exchange who were hired on or after January 1, 2010 do not receive an Exchange HRA contribution unless he or she has more than 15 years of service.
Years of Service Contribution
5 $55.00
6 $66.00
7 $77.00
8 $88.00
9 $99.00
10 $110.00
11 $121.00
12 $132.00
13 $143.00
14 $154.00
15 (Base) $165.00
16 $176.00
17 $187.00
18 $198.00
19 $209.00
20 $220.00

Retirees enrolled in a medical plan through the One Exchange can check the status of the HRA claim reimbursement at One Exchange or by calling (888) 598-7545.

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Updated July 16, 2015


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