Priority HRA

Two great ways to reduce your Clients’ Healthcare costs!

 A Priority HRA is a special type of Group Coverage HRA that reimburses expenses only from select merchants or providers

A priority HRA from Empower is the perfect plan for the following types of Employers:

• Hospitals, Pharmacies, and Medical Providers who want to incentivize employees to purchase their medical products and services from the Employer. For example, the HRA only reimburses expenses from the Hospital’s pharmacy. This is a win-win for both the Employer and employees.
• Employers in small markets where a major provider in the area is out of network. For example, if a major local clinic loses its in-network status for the Employer’s health plan, the HRA can reimburse expenses only for that clinic to ease the employees’ out-of-network costs.

How it Works

1. The Employer determines which merchants and/or expense categories that the HRA will reimburse.
2. EMPOWER reimburses only claims submitted for the merchants and/or expense categories outlined in the Plan.

Scenarios

Scenario A: Hospital

Goal: A Hospital wants to offer an HRA that reimburses all 213(d) expenses, but wants to reimburse prescription expenses only from the Hospital’s on-site pharmacy.

Solution: Empower can implement a Priority HRA with a debit card that is enabled for all eligible expenses except for prescription expenses. To use HRA funds for prescriptions, employees would submit a claim to Empower along with a receipt. Empower would ensure that the receipt matched the Hospital’s on-site pharmacy before approving the claim.

Scenario B: Out-of-Network Provider

Goal: The main clinic in an Employer’s town moves to out-of-network for the group health plan. The Employer wants to reduce the employees’ additional costs caused by the out-of-network clinic.

Solution: Empower’s Priority HRA can reimburse expenses only from the out-of-network local clinic either 100% or using a reduced coinsurance percentage. Restricting to specific local clinics prevents HRA funds being used for in-network clinics in nearby cities.