Health Reimbursement Account
Each plan year your employer contributes a specified amount to your HRA — you cannot make an additional contribution. You are not taxed on the value of your HRA or the reimbursements you receive from the account. Note: Expenses reimbursed under your HRA may not be used to claim any federal income tax deduction or credit.
Example: Your HRA plan year begins in January and your employer contributes $100 each month. In February, you have $200 in your account, but you incur an expense for $300. If you submit a reimbursement request that same month, you will be reimbursed for $200 of the expense, and you will receive the additional $100 when your employer puts the $100 March contribution into your account.
After you complete the Request for Reimbursement Form, submit the form along with appropriate supporting documentation.
- For office visits and other services — Your health plan’s Explanation of Benefits (EOB) statement or an itemized receipt or bill from the provider that includes the patient’s name, a description of the service, the original date of service and your portion of the charge.
- For prescription drugs — A pharmacy statement or receipt from your pharmacy including the patient’s name, the Rx number, the name of the drug, the date the prescription was filled, and the amount.
- For over-the-counter medicines — A written or electronic OTC prescription along with an itemized cash register receipt that includes the merchant name, name of the OTC medicine or drug, purchase date, and amount, OR a printed pharmacy statement or receipt from a pharmacy that includes the patient’s name, the Rx number, the date the prescription was filled, and the amount.
- For over-the-counter health care-related products — An itemized cash register receipt with the merchant name, the name of the item/product, date, and amount.
Credit card receipts, canceled checks, and balance forward statements do not meet the requirements for acceptable documentation.
For some expenses, a Medical Determination Form from a doctor may be required.
For answers to your questions about your HRA, please contact Lynda Rodarte at United Administrative Services, (408) 288-4433.
To find out your HRA balance or if you have questions regarding your HRA card, please contact Navia Benefits at (866) 897-1996 or email@example.com