Page 12 - 2013-14 NCACU Benefits & Notices
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North Central Area CU 2013-14
Health Reimbursement Arrangement (HRA)
A Health Reimbursement Arrangement (HRA) is an IRS-approved program which allows the Credit
Union to share in the cost of specific expenses within designated health plans.
The PPO plan is an HRA plan. If you choose this plan, the Credit Union will assist you in paying part of
the deductible should you or a covered family member require a service(s) subject to the deductible.
Here is how it works:
HRA SB PPO 2500
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The Benefit Year* for the HRA is January 1 to December 31 .
IN NETWORK Deductible: $2,500 Single / $5,000 Family
NCACU pays up to the entire
$2,500 of each single IN NETWORK deductible
$5,000 of each Family IN NETWORK Deductible
Maximum deductible exposure for Employee:
$0 Exposure on IN NETWORK deductible
(Employee responsible for all/any OUT OF NETWORK costs)
20% Co-insurance Following Paid IN NETWORK Deductible
IN NETWORK Co-insurance Maximum $2,500 Single / $5,000 Family
Employee pays up to $2,500 of each single IN NETWORK co-insurance maximum and
up to $5,000 of each Family IN NETWORK co-insurance maximum.
NCACU pays $0 of IN NETWORK co-insurance
Maximum deductible exposure for Employee:
$2,500 Exposure on each single IN NETWORK co-insurance / $5,000 of each Family
(Employee responsible for all/any OUT OF NETWORK costs)
Process to Receive Credit Union Paid Portion of the IN NETWORK Deductible
(1) Provider bills services to BCBSM
(2) Employee receives EOB (Explanation of Benefits) from BCBSM for services
(3) Employee sends EOB(s) along with HRA Claim form to EBC for processing
(4) EBC electronically deposits CU portion in employee’s designated Checking or Savings account
(5) Employee pays billed deductible with funds received from EBC
* BENEFIT YEAR IS DEFINED AS THE TWELVE (12) MONTH PERIOD DURING WHICH THE PATIENT OUT-OF-POCKET MAXIMUMS
ACUMMULATE. AT THE BEGINNING OF EACH BENEFIT YEAR OUT-OF-POCKET MAXIMUMS RESET TO ZERO.
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