Medical: EBC HRA: All You Need to Know

What is your Health Reimbursement Arrangement (HRA)?

The Austin Stone Health and Wellness Plan has two main components: 1) A membership with Christian Healthcare Ministries (CHM) and 2) The Austin Stone Component consisting of a Health Reimbursement Arrangement (HRA), Employee Out of Pocket Deductible, and the Austin Stone Health Fund.  

The Health Reimbursement Arrangement (HRA) is a health account that the Austin Stone funds for you to pay for eligible Health and Wellness Plan expenses that are not reimbursed by CHM.

Every January 1st, your HRA account clears out any remaining funds from the prior year and resets your available balance based on your coverage level:

• Employee Only - $1,650
• Employee + Spouse - $2,750
• Employee + Family - $5,500

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What are Eligible HRA Expenses?

You should always first consider if your medical bills are eligible to be reimbursed by Christian Healthcare Ministries.  If they are, then follow these instructions on How to Submit Bills to CHM.  If they are not, then consider if they are eligible HRA expenses.  

What medical expenses are you allowed to use your HRA to pay for?   This is an incomplete list, but should help you understand what is eligible.

• maintenance prescriptions
• chiropractic and Airrosti treatment (limited up to: employee only $750, employee + spouse $1,125, and employee + family $1,500) - you must track your spending and stay within these limits
• mental health care (including prescriptions) that is for a diagnosed condition (such as depression, anxiety, PTSD, etc.).  Care must be provided by a licensed psychologist, psychiatrist, or counselor.
• immunizations
• bills that are part of an incident with an incident total of less than $1,000 (sum of all pre-discount costs of bills for the incident)
• contacts or glasses (up to $100 per year for each covered person) and one eye exam per year for each covered person
• ambulance services that are not eligible for reimbursement by CHM
• out-of-pocket dental expenses (limited up to: employee only $750, employee + spouse $1,125, and employee + family $1,500)
• Hearing Aids
  • Child (18 years of age or younger) : Coverage for the cost of medically necessary hearing aid or cochlear implant and related services and supplies.  Coverage is limited to one hearing aid in each ear every three years and one cochlear implant in each ear with replacement as medically or audiologically necessary
  • Adult: Coverage for the cost of recommended hearing aid or cochlear implant and related services and supplies.  Coverage is limited to $3,000 per covered person every three years.

What medical expenses are you NOT allowed to use your HRA to pay for?

• bills that are eligible to be reimbursed by CHM...i.e. bills that are part of an incident that has an incident total of more than $1,000 (sum of all pre-discount costs of bills for the incident)
• acupuncture
• over the counter medications
• alternative, experimental, and investigational care or treatment and clinical trials (treatment that does not have an associated numerical CPT code)
• naturopathic, functional, or holistic medical care provided by unlicensed physicians
• orphan drug prescriptions
• cosmetic surgery
• marital and social counseling
• counseling or therapy that is not for a diagnosed condition such as anxiety, depression, or PTSD
• nutritional supplements - even if prescribed
• abortive procedures
• embryo implant procedures

EBC/HRAs, in general, may cover a variety of medical expenses. However, not all of them are covered by the Austin Stone Health and Wellness Plan. Here is a helpful document that compares what EBC/HRAs in general can cover versus what the Austin Stone Health and Wellness Plan does cover through our HRA.

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Employee Benefits Corporation (EBC)

Employee Benefits Corporation (EBC) is the third party administrator of our Health Reimbursement Arrangements (HRAs).

• App: EBC Mobile This app is very easy to use and super useful!

  

• Phone Number: 1-800-346-2126 or 608-831-8445
• Website: www.ebcflex.com (log in as a participant)
• Address:  Employee Benefits Corporation, P.O Box 44347, Madison, WI 53744
• EBC HRA Card: EBC will mail you a debit card that you can use to pay for eligible HRA expenses.  This card expires three years after it was issued.  EBC will automatically send you a new card at the beginning of the month in which the card will expire.

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How to: File a Claim with EBC

Did you pay for something with your personal credit card and then realize that you could have used your EBC HRA Benefits card for that expense because it is an eligible HRA expense?   Well, you are in luck!  

You can file a claim with EBC to be reimbursed from your HRA via Direct Deposit.  Here's how:

1) Open the EBC Mobile App

2) Log on and select the Submit a Claim icon on the bottom of the screen:

3) Fill in all the data from and attach an image of your itemized bill or pharmacy receipt.

4) Scroll down the screen and click the green Next button.  Accept the terms on the next screen.  You should receive a Direct Deposit to the account EBC has on file with in two weeks and your HRA balance will be deducted accordingly.

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How to: Submit Documentation to EBC

Did you receive an email from EBC titled "Submit your Benefits Card documentation"?  This means you used your EBC Benefits card to pay for a medical service and you need to provide EBC documentation to substantiate the charge....the itemized bill/receipt/statement you received from the provider.

EBC expense documentation must include:

• Date(s) of Service
• Type of expense
• Amount of the expense incurred
• Name of Service Provider

You can upload documentation to EBC via the EBC app or at www.ebcflex.com. 

Here's how to use the app:

1) Open the EBC Mobile app.

2) Log on and select the Transactions icon on the bottom of the screen:

3) On the Transactions screen, you will see the claim that needs documentation by the red Action Required status. Click the transaction and upload a picture of your itemized bill or pharmacy receipt.

How long do you have to provide EBC with the documentation?

1) Once EBC notifies you that documentation is required to substantiate a claim, you have 42 days to provide that documentation. If you do not provide the documentation, your EBC Benefits card will be suspended*.

2) If you provide documentation for a claim and that documentation was not sufficient, then EBC will notify you that you must provide sufficient documentation within 14 days, or your EBC Benefits card will be suspended*.

3) EBC will activate your card within one day of receiving sufficient documentation. 

*When your EBC card is suspended, you still have access to your HRA funds. You have just lost to benefit of using the EBC card to pay at the time of service...you must pay with your personal funds. Make sure to get a valid receipt or itemized bill and then follow the steps in the How to: File a Claim section at the top of this document.

You may wonder why sometimes EBC requires documentation for a charge and sometimes it does not.

One factor is whether or not the provider has an inventory information approval system (IIAS). This system requires the provider’s systems to have the ability to verify that the item being purchased with a HRA card is an eligible medical expense, as defined by the IRS. The provider’s system compares the items being purchased against a pre-established list of eligible medical products. The provider’s system totals the eligible medical expenses and transmits this information to the card issuer (EBC) for approval, subject to coverage under the health plan (i.e., type of coverage provided, covered participant, etc.). If the provider has an IIAS system and the charge made was an eligible expense, then EBC will not require documentation be sent in.

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How to: Repay Your HRA

If you used your EBC card to pay for something that...

• is not an eligible HRA expense ~or~
• is a charge that is part of a CHM claim ~or~
• you are unable to provide sufficient documentation (itemized statement) to EBC for... ...then you need to repay your HRA for that expense!

There are two ways you can repay your HRA: 

1) By withdrawal from you bank account on file

• Call 1-800-346-2126 or 608-831-8445 and speak with a service representative about repaying your HRA.
• OR Email participantservices@ebcflex.com > Note: If you choose the option to email, you may have to email more than once to receive a response. EBC will likely respond with an email requesting that you verify the last four digits of the bank account you have on file with them for direct deposit before they will withdraw the funds from your bank account and repay them to your EBC account.
• Include the following information in your email:
  • Name of account holder (even if this is for a different family member's claim, you need to use the employee's name who holds the account)
  • The last four digits of the account number (this is the last four digits of account holder's SSN.)
  • Claim ID # that you are repaying (you can find this by clicking on the "transactions" in your EBC mobile app, or looking at "processed claims" or "upcoming payments" in your EBC portal)
  • Explain in the email that you need to repay your HRA for a charge and indicate the amount EBC should withdraw from the account they have on file. (You can verify the account they have on file for you by logging onto www.ebcflex.com, clicking on the Menu in the upper left, then Direct Deposit in the Manage section.) Example: "I would like to repay my HRA for $45.65 for the charge on MM/DD/YY. Please withdraw the funds from my account on file."
• A representative should send you an email confirming and asking for your authorization. You need to respond to the email authorizing the withdrawal from your bank account. Once authorization is received, EBC will process the withdrawal of funds.

2) By check

• Write a check made out to "EBC" for the amount you need to repay. 
• In the Memo line of the check, write the account holder’s first name, last name, and last 4 digits of their social security number. (The ASCC employee is the account holder.) 
• On a separate piece of paper or sticky note, write a short message stating the purpose of the check. It is very important to include the date of the expense that you are paying back so that EBC manages the refunds for the correct plan year. 
  • Example: This check is to repay my HRA for the transaction dated 3/2/2019 in the amount of $100.00. 
• Mail the check and note to EBC, P.O Box 44347, Madison, WI 53744. 
• It may take up to six weeks for these funds to be reimbursed into your HRA. Keep on the lookout to ensure the funds are added to your HRA balance.

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How to: Activate a Deactivated Card

Did your EBC card get deactivated because you did not provide documentation for a claim?  If so, here are some important details for you to know:

1)  Your EBC card gets deactivated if, 

-you have not provided documentation to substantiate a claim within 42 days of being notified, or -you have provided insufficient documentation for a claim and have not provided sufficient documentation within 14 days of being notified.

2)   If your EBC card has been deactivated, you do still have access to your HRA funds.  You may pay for services using your personal credit card, file a claim for reimbursement, and receive reimbursements from EBC.  You have just lost the quick access functionality of using the EBC card.  Follow the steps in the How to: File a Claim section at the top of this document.

3)  Your EBC card will be reactivated when you do one of the following,

-you provide EBC with valid documentation to substantiate your claim:

(How to: Submit Documentation to EBC),

or

-you repay your HRA for the amount of the charge that requires documentation:

(How to: Repay Your HRA).

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How to: Report a Fraudulent Charge on your EBC Card

If you suspect a fraudulent charge on your EBC card, it is important that you notify EBC immediately. You will need to complete a Cardholder Dispute Form within 55 days of the date of the charge that you are disputing. After completing the form, the form should be submitted to EBC by faxing to (608) 831-4790.

How to: Replace or Get New EBC HRA Card

Lost your card?

You, the account holder, can call EBC at 1.800.346.2126, select 1 for Customer Service, and select 2 for Help with your Benefits Card.  The Customer Service representative will assist you in getting a new card sent out.  Note: EBC cannot send out a new account holder card if your spouse calls to request...The request must be made by you.

Card about to expire?

Each EBC HRA card expires three years after it was issued.  EBC will automatically send you a new card at the beginning of the month in which the card will expire.

Order a second EBC Benefits Card for your spouse!  

1.  Log onto www.ebcflex.com.

2.  In the upper left corner, click on the MENU button...

3.  In the Manage menu on the right side, click the words "Secondary Benefits Card"

4.  On the Secondary Benefits Card page, click the Add button.

5.  Enter the First Name and Last Name of you spouse and click Add.

6.  That's it!  You will see your spouse listed with a Requested Date on the screen and EBC will mail a card to your home with your spouse's name on it.