Employers Can Now Enjoy A Reduction In Health Care Spending
Employers are constantly battling the burden of ever-increasing health care expenses on their group members that is making it more and more difficult to meet their health care expense obligations. The Health Matching Reimbursement Account (HMRA®) cost-containment program represents the missing piece in group plan design for employers to not only contain their health care cost increases but to actually experience dramatic savings over time and reduce these burdens.
The Employer’s HRA: HMRA Is The Ideal Funding Vehicle For Self-Funded And HRA Groups
The HMRA is a patent-protected product offered exclusively by National Prosperity Health Matching Services, Inc. The HMRA is “The Employer’s HRA” because it is a medical reimbursement account program owned by the employer. The HMRA is a cost-containment tool and funding mechanism that in a self-funded arrangement reimburses employers on the first-dollar of employee health care expenses regardless of cost sharing and plan design when group members incur medical claims.
The HMRA is also the ideal complement to any employer’s HRA program because the HMRA Program and its powerful, medical benefit crediting can be used as a funding vehicle for the employer’s HRA program itself. The HMRA can be implemented by employers to fund a separate, Section 105 HRA plan design to pay for any of their 213(d) medical expenses up to the group member’s current account balance at the time of the claim.
The Health Matching Reimbursement Account HMRA product is a HIPAA (Health Insurance Portability and Accountability Act of 1996) compliant, medical reimbursement account program. The HMRA program consists of a defined, monthly, employer contribution on behalf of their participating group members. This monthly, employer contribution is fully tax deductible as a Sec. 162 business expense and is allocated towards participating group members into their separated, HMRA account balances per employee.
These group member HMRA account balances all awarded a first-dollar, medical benefit crediting that grows every month following each employer contribution on behalf of the group as a whole. Employers will receive up to $2 in benefits or more to be used as medical reserves inside of their group members’ HMRA accounts for every $1 contributed each month as the program progresses.
The HMRA Program reimburses self-funded employers in full for all first-dollar, member medical claims irrespective of cost sharing up to the member or family’s HMRA account balance at the time of the claim. For employers who have an HRA program, the HMRA benefits can be accessed by the employees for their HRA.
HMRA member account balances are allowed to carry over year-to-year as long as the member stays in the group. The growth of the members’ HMRA account balances every month across the entire group serves to help pre-fund member claims by increasing an employer’s medical reserves and reducing the future, contingent liabilities or HRA costs on each participating member.
The HMRA serves to save employers money on their members’ actual claims themselves. Through this pre-funding of claims with the HMRA and the resulting medical benefit crediting, the employer will be receiving additional reimbursement and payment funds flowing into the company that would not have been possible without the HMRA program in place.
The HMRA program can be customized for each employer group. Health Matching contribution levels are designed to be flexible in order to accommodate any employer seeking to build medical reserves and significantly reduce their health care obligations by pre-funding member claim obligations through individual or family HMRA account balances. National Prosperity Health Matching Services (NPHM™) offers 11 different levels of HMRA® contribution programs that the employer can select from for each of their group tiers and family structures with corresponding target account balance caps per member or family ranging from $2,500 all the way up to $60,000. These member account balances are permitted to build up and carry over year-to-year even if the benefits are not used.
Once group members begin to hit their target account balance caps, the employer is no longer responsible for allocating the full portion of their monthly contribution towards that group member’s HMRA account balance (only small maintenance fees will be required on behalf of that member). This will serve to decrease the total, monthly amount contributed towards the HMRA program while the employer still retains all of the medical reserves that have accrued for each group member or family in the process.
Sample HMRA Contribution Levels Per Member
- Health Matching Reimbursement Account contribution levels can be adjusted per group tier or family structure to fit any employer budget
- Employers can select from different account balance level maximums per group tier or family structure
- No further monthly, employee contribution by employer once member account balances reach target account balance cap (only small maintenance fees required on behalf of those members)
No Disruption to Group Plan Design
Regardless of the group, the HMRA is a complementary piece to what the employer is already doing in order to enhance their plan design. By implementing the HMRA program, employers create no disruption to their group’s existing plan design or network coverage expectations. In a self-funded employer arrangement, the NPHM™ Services, proprietary, HMRA Helix administrative system will already be seamlessly integrated with the employer’s administrator and their claims adjudication system in order to automatically issue claims reimbursements back to the employer every month based on the enrollment and claims file feeds that are provided. For HRA groups, the HMRA simply serves as the behind-the-scenes funding vehicle for the HRA program that group members will be able to access. The HMRA program can complement any employee cost-sharing arrangement that is already in place.The HMRA benefits will be covered in the employer’s HMRA Administrative Services Only (ASO) agreement.
Additional Discounts for Pharmacy and Telemedicine Included
By enrolling their groups in the HMRA program, employers are also eligible to receive unlimited, monthly, telemedicine access for their group members with no copays already included in the monthly, HMRA contribution through various, NPHM preferred, telemedicine partners. Each employer will also have the opportunity to enroll in the NPHM Rx Program. This exclusive, PBM (Pharmacy Benefit Manager) program is only available by enrolling in NPHM Services products and delivers significant savings to our cardholders on prescription drugs, diabetic care services and daily living products.
Unlike a traditional PBM discount card plan where, in most cases, the cardholder would pay a monthly, cardholder fee in order to receive a discount on their pharmacy drug costs, the NPHM Rx Program requires no monthly or annual fee and secures NPHM customers much deeper cost reductions than a conventional discount card would. These valuable pharmacy and telemedicine savings for the employer are an ideal complement to the HMRA product that will already be saving the employer on their annual medical expenses. With the HMRA, employers can now lower their group health care costs even further by offering an enhanced, employee benefits package that provides comprehensive coverage and discounts on major-medical services.
Employers Can Now Reduce Both Their Fixed and Variable Health Care Costs
The revolutionary, Health Matching Reimbursement Account (HMRA®) program reduces an employer’s costs, risk and exposure to health claims in the most expensive and frequent levels of claims. The HMRA creates additional, member claims reimbursements flowing back to the employer that would not have been possible before. These reimbursements serve to lower an employer’s variable costs because their HMRA medical reserves will be covering additional portions of their members’ claim exposure. Furthermore, because of the wealth of medical reserves accumulating in each participant’s HMRA account balance, an employer’s fixed costs and future, contingent liabilities (including future HRA costs) can also be reduced because the HMRA will allow employers the opportunity to increase their deductibles and secure lower premiums for themselves or their employees since the HMRA will be covering an increasing portion of their first-dollar risk.
The HMRA program provides unsurpassed benefits for employer groups of all sizes that will increase a company’s financial strength by allowing it to retain capital that would normally be allocated for employee health care expenses. NPHM Services strives to be a true partner for employers and provide them with a brighter financial outlook by drastically lowering their group’s health care-related exposure and contingent liabilities over time even in a climate where the trend for more than two decades has called for health care expenses to continue to increase for employers every year.