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Certain claims require a Letter of Medical Necessity.
A Letter of Medical Necessity (LOMN) is required before we can reimburse certain claims. Common examples include massage therapy, vitamins and supplements, and weight loss programs—all of which are often used to benefit general wellbeing. An LOMN confirms when these types of services, products, and programs are necessary to treat a diagnosed medical condition.
An LOMN is like a prescription, but with more detail explaining why the patient needs a specific treatment, product, or service. An LOMN must include a medical diagnosis and recommended treatment plan from your doctor or medical care provider. We will let you know if you submit a claim that requires an LOMN. To learn more, log in, click Resources, and search for “Letter of Medical Necessity.”
Get your Form 1095-B online on or after January 31, 2025.
If your HRA qualified as “minimum essential” coverage during any month in 2024, we will furnish you with a Form 1095-B. On or after January 31, 2025, log in to access and print your form. Form 1095-B is informational only—just keep it with your tax documents. You don’t need to file it with your individual return. If you need a paper copy, give us a call on or after January 31, 2025 at 1-844-342-5505.
HRA tax reporting is required only in certain cases.
HRAs are generally tax-exempt and don’t require any tax reporting. However, if you’re the divorced spouse or, in rare cases, a non-dependent survivor of a deceased HRA participant*, you must report the value of your HRA coverage as taxable income. In these instances, be watching for a Form 1099-MISC and instructions from us in the mail.
*This would be a rare circumstance. Federal law prohibits most HRA plans from providing or transferring benefits to non-dependent heirs of deceased participants.
If you’re no longer working for the employer who set up your HRA, make sure we have your separation date on file.
If you’re no longer working for the employer who set up your HRA, make sure we have your separation date on file. This is especially important if your HRA was fully claims eligible while you were working. Medicare should be primary to your HRA. But, if we don’t have your separation date, Medicare will consider your HRA to be primary and can take your HRA funds to cover prior Medicare claims.
Here’s what you should do: Log in and check to see if we have your separation date on file, it will be displayed on your dashboard (landing page) inside the box with your account balance. If you don’t see your separation date, click the envelope icon at the top right of your screen to send it to us using our Secure Messaging Center. You can also reach us at 1-844-342-5505.
Electing “limited HRA coverage” helps protect your HRA in certain situations.
If your HRA is fully claims eligible and any of the situations listed below apply to you, you should consider limiting your HRA coverage to help avoid future hassles.
- Medicare Coordination. You’re still employed by the employer who set up your HRA and you, your spouse, or a dependent have Medicare coverage, and you don’t want to be forced to use up your HRA funds before Medicare will pay claims.
- HSA Eligibility. You, your spouse, or a dependent are making or receiving contributions to a health savings account (HSA). To be eligible for HSA contributions, IRS rules require that you have no other first-dollar coverage. This includes full HRA coverage.
- Premium Tax Credit Eligibility. You, your spouse, or a dependent are purchasing insurance through a marketplace exchange and are taking the Premium Tax Credit (subsidy).
You can avoid potential problems by electing limited HRA coverage for yourself, your spouse, and/or a dependent as needed. Just complete and submit a Limited HRA Coverage Election form. The form, which contains more details, is available online. Log in and click Resources.
Are you a retiree-rehire with a post-separation (retiree-only) HRA?
If you leave employment with a post-separation (retiree-only) HRA and are later rehired by the employer who set up your HRA, your HRA coverage will once again be subject to the same in-service limitations that applied before separated or retired. Depending on your HRA plan design, you may or may not be eligible to file claims for certain types of expenses incurred during re-employment. However, you may still file claims for qualified medical expenses incurred prior to re-employment while your HRA was fully claims eligible. Your HRA may once again provide full coverage after your re-employment ends.
The above retiree-rehire limitation applies to post-separation HRAs only. If you have an HRA with in-service claims eligibility, you may continue to file claims without limitation.
You can keep filing claims while on military leave.
You can keep filing claims if you’re on military leave governed by the Uniformed Services Employment and Reemployment Rights Act (USERRA) and have a claims-eligible HRA. Also, you can make voluntary after-tax contributions to your HRA under COBRA if your employer has stopped making HRA contributions due to your military leave. Certain restrictions may apply.