Page 11 - 2013-14 AAACU Benefits & Notices

Alpena Alcona 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 PPO 15/0

IN NETWORK Deductible: $5,000 Single / $10,000 Family

Alpena Alcona Area Credit Union pays up to $4,750 of each single /
$9,500 of each Family IN NETWORK deductible
Employee pays the first $250 of single IN NETWORK deductible / $500
of family IN NETWORK deductible

Maximum deductible exposure for Employee:
$250 Exposure on single IN NETWORK deductible
$500 Exposure on family IN NETWORK deductible

(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) BCBSM claim information to HEQ for processing
(4) HEQ pays the provider with funds due from AAACU.
(5) Employee pays first $250/$500 of billed deductible, if not already paid for the year.

Summary of Benefits & Coverage

In accordance with the changes mandated by federal health care reform effective the first plan year
following 09/23/2012, this is your Summary of Benefits & Coverage (SBC) for our medical plan.

The purpose of the SBC is to provide an explanation of your medical and prescription benefits (if any) in
an easy to read format. The SBC should look the same for any health plan from any employer since the
format, developed by the federal Department of Labor (DOL), is mandatory.

The SBC should be used in conjunction with the benefit summary of your medical coverage from CUA
and the benefit guide found in the Member Section of the carrier’s website. Click here to view your SBC.

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