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HRAs fit well in the new health care model

New health care laws are driving significant change in the workplace. We’re at a crossroads, with an unprecedented volume of regulations issued as a result of the Patient Protection and Affordable Care Act. These changes require new paths to be paved—or at least patched—especially surrounding the popular health reimbursement arrangements.

But some in the consumer-directed benefits industry aren’t sure where to go next with HRAs, as PPACA is underway. To keep HRAs as part of health care choices, employers need to start preparing now.

First, employers who are already offering HRAs as part of an overall plan can keep the current arrangements as it. If that’s not the case, it’s important to take a look at the purpose of the HRAs, how much is being spent on them and whom they are or should be benefiting.

To maintain these popular benefits for employees, there are some minor changes that can be made in the eligibility or the plan design to help fit the new health care rules. Following are a few options for employers to consider:

  1. Ensure your HRA is integrated by covering only those employees who are enrolled in your company’s health plan.

The old rules allowed for anyone to have an HRA. Not so starting Jan. 1, 2014. While current account holders can continue to have HRAs and spend them down until there’s no money left in them, standalone HRAs may go away without further regulatory relief. New PPACA rules require any employee taking advantage of the reimbursement arrangements to be covered under a PPACA-compliant group health care plan. The good news here is that HRAs can be paired with any type of health plan, as long as it meets the minimums established by the PPACA.

  1. Allocate employer dollars to employees through a health flexible spending account . The addition of an FSA with an HRA provides an opportunity for employers to supplement or replace HRAs and gives more options to employees.
  2. Amend your HRA to provide only vision and dental coverage in order to preserve an annual dollar limit available to participants.

Dental and vision insurance needs tend to be much more predictable. Using an HRA here, both employers and employees are able to better anticipate needs and budget appropriately.

  1. If you rehire a company retiree, you may inadvertently jeopardize a retiree-only HRA. Retiree HRAs can continue to be offered as long as they cover only retirees.

Employers and employees alike are continuing to try and wrap their heads around the new rules and regulations of health reform. Me and my colleagues are continuing to ask for clarification on a range of subjects, including:

  • The impact to the HRA of an employee who is covered under his or her spouse’s group health plan. For example, if a spouse carries the coverage for an employee’s family, does the employee have to forego any employer HRA simply because they waive health care coverage from their employer to avoid duplicate coverage?
  • Whether a category of excepted benefits can be created to include smaller, stand-alone HRAs, thus allowing employers to continue to help their employees defray their out-of-pocket health care costs.
  • Whether a premium-only HRA will be allowable under the current law. These plans are used to help employees purchase coverage and are particularly popular for smaller employers who want to define a contribution level for employees’ health coverage but cannot afford to carry that coverage or the administrative overhead to administer it.
  • Whether an HRA that qualifies as an FSA may still be allowed under current interim      regulations.

Questions about the new path of HRAs remain and we’ll continue to ask them. In the meantime, keep in mind these possible plan changes as the new health care model shapes a new path for HRAs.