How to submit HRA/DED claims

This article illustrates the process the participant will follow to activate their health reimbursement arrangement (HRA).  
Written by Michele Lombardo
Updated 6 months ago

An HRA plan with a deductible account (DED) requires participants to meet an out-of-pocket responsibility before they can be reimbursed from the HRA. The HRA will remain inactive until the participant meets their DED balance and activates the HRA. 

This article will help illustrate the process the participant will follow to activate their HRA. 

If a plan requires activation of the HRA account prior to paying out expenses from the HRA, the participant will need to complete the following steps. 

  1. The participant must show that they have paid their out-of-pocket responsibility. 
  2. The participant incurs an expense and obtains an explanation of benefits (EOB) for the expense. The EOB will show the total the participant has paid out of pocket for the plan year. The most recent EOB will suffice as long as the expenses incurred meet or exceed the total of the DED account at Ameriflex. 
  3. The Participant will submit the EOB mentioned above online through their Ameriflex account or through any of our standard claim channels.
  4. The participant can wait until they have met the full deductible amount prior to submitting a claim instead of loading each individual expense throughout the year. 
  5. Once the DED has been updated to reflect as having been met and activation is completed, the participant will be able to submit claims with EOBs towards the HRA for reimbursement. They can also use their Ameriflex card for expenses if the employer allows for card transactions against the HRA plan. 

**HRA plans can differ based on the employer’s plan options. To better understand how your plan works, please review your plan documents to see what requirements are listed. Your employer should have provided you with access to those plan documents.**

Related Articles: 

Reimburse out of pocket claims

How to find HRA rules in the Ameriflex portal

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