1 | Who is NPHM™ Services?
National Prosperity Health Matching Services, Inc. is based in Houston, Texas and is the exclusive provider of Health Matching Reimbursement Account products. NPHM Services is a privately-managed, financial services company and first-dollar, medical cost-containment company. NPHM Services is committed to bringing down the cost of health care in the group and individual markets.
NPHM Services is expanding its reach and forming partnerships with some of the largest brokers, benefit agencies and administrators all across the country in the ERISA market to promote its revolutionary, Health Matching Reimbursement Account (HMRA®) program for employers. In addition, NPHM Services is also offering a version of its Health Matching Reimbursement Account Program for employees and individuals referred to as the HMA™ Medical Benefits Account .
The NPHM Services Board of Directors and founders bring over a century of experience in the life and health services industry. It is comprised of a CLU (Chartered Life Underwriter) and ChFC (Chartered Financial Consultant) as well as the former Deputy General Counsel for Health and Human Services in Pennsylvania. The founders are former owners of one of the largest independent companies in the southwest United States.
2 | How does NPHM Services award the HMRA benefits?
This fully HRA and HIPAA compliant product was designed for implementation by one of the most renowned life and health services actuarial firms in the world today. Health Matching Reimbursment Accounts utilize in-depth pooling and claims frequency analysis to determine the rate of growth on contributions that can be awarded monthly into member account balances. The National Prosperity Health Matching Services claims exposure is capped at each participant’s account balance, and these balances can only be used for the employer to be reimbursed on qualified 213(d) medical expenses since these accounts contain no cash value. NPHM Services also maintains millions of dollars of its own reserves to back their programs.
3 | What is the legal overview of the HMRA program?
The Health Matching Reimbursement Account (HMRA®) is a patent-protected product offered exclusively by National Prosperity Health Matching Services, Inc. The HMRA is a HIPAA compliant medical reimbursement program. The HMRA is an employer-sponsored, medical savings account and reimbursement program. The HMRA awards a medical benefit crediting on the employer’s monthly contribution designated to each participating group member’s account balance in order to fund employee HRA programs or reimburse the employer for any employee or group member’s, first-dollar, 213(d) medical expenses, regardless of cost sharing, up to the member’s HMRA account balance at the time of the claim.
4 | How are the employer’s HMRA funds protected?
The employer’s HMRA contributions will be held in a collateral account with National Prosperity Health Matching Services, Inc. National Prosperity legally guarantees its HMRA program, which includes the medical benefit account crediting as well the monthly, reimbursement arrangements that are put in place through the employer’s HMRA Administrative Services Only (ASO) Agreement.
5 | What are the group size requirements for the HMRA?
The HMRA is ideal for any group (self-funded or fully-insured) with 20 or more members that has less than a 50% annual employee turnover rate. The HMRA reimbursements will serve to lower an employer’s fixed (plan premiums) and variable (employee claims) health care costs as well as their contingent liabilities and is also the ideal way to ease fully-insured groups into self-funding. For those groups that do not meet these specifications, the employer may opt to offer the voluntary version of the HMRA known as the HMA Medical Benefits Account to their group members instead. Your employees’ HMA accounts would be portable with them if they leave the organization.
6 | What if a group already has an HRA program already in place?
The HMRA does not need to be utilized as a replacement for either a traditional HRA or an employer-sponsored HSA program. The HMRA program builds tremendous savings for employers through the growth of the HMRA first-dollar, medical reserves received following member health claims. These HMRA benefits can instead be treated as a complementary piece by serving as the funding vehicle for the HRA program itself.
7 | Does the HMRA program work with employer plans that are not high deductible?
Yes. The HMRA is compatible with low or high deductible employer plans. In a self-funded arrangement, the HMRA medical reserves and claim reimbursement incentives decrease an employer’s first-dollar, claims exposure (variable costs) while also enabling them to reduce their fixed costs by increasing their specific deductible levels. This is because the HMRA account balances will be covering such a large portion of the employer’s claims cost risk as the HMRA medical reserves continue to build.
For fully-insured and HRA groups, the growth of HMRA medical reserves to cover future employee health care costs creates opportunities to safely increase the employer or the employees’ deductible levels in order to further lower everyone’s fixed costs and employer contingent liabilities. The HMRA also enables fully-insured groups the option to ease their way into self-funding because the wealth of reserves growing earned inside of the HMRA program provides protection for the group to guard against future, health care cost increases. The medical reserves building inside the HMRA program can be used to reduce the group’s underlying health plan costs as well as decrease the employees’ cost-sharing because the HMRA will be covering such a large portion of the overall, employer risk to health claims.
8 | What happens to HMRA account balances when members leave an employer group?
The HMRA Employer Return of Benefit Rider was designed for employers that have much higher than average annual employee turnover rates and comes included for all HMRA groups. As opposed to relinquishing the HMRA account balances of all departed employees, employers can opt to allocate a portion of those benefits from employees that have terminated and have them spread equally and added to their remaining employees’ HMRA account balances in order to neutralize the cost of employees leaving the plan.
9 | Can Employers duplicate the HMRA program themselves?
The HMRA program and the HMRA Helix administrative software is proprietary and patent-protected. National Prosperity Health Matching Services, Inc. is the exclusive provider of the HMRA program. The HMRA product was designed over many years with the help from one of the most renowned actuarial firms in the world, who utilized in depth, claims frequency and utilization analysis to build this program. This program would not be safe to be attempted by a third party due to its intricate structure and associated risks.
10 | What if Employers wants to change their monthly contribution amounts or target account balance caps?
HMRA contribution levels are designed to be flexible in order to accommodate employers seeking to build reserves and significantly reduce their health care obligations. National Prosperity Health Matching Services (NPHMTM) offers different levels of HMRA contribution programs 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 and is only responsible for small maintenance fees. If the employer wishes to decrease or increase their monthly contribution level and corresponding target account balance cap on their group members, they will be permitted to do so each year on their annual, HMRA anniversary date.
The HMRA-HRA Medical Benefits Visa® Prepaid Card is issued by The Bancorp Bank pursuant to a license from the Visa® U.S.A Inc. The Bancorp Bank; Member FDIC. Card may not be used everywhere Visa® debit cards are accepted. See Cardholder Agreement for list of eligible goods, services and merchants. Health Matching Reimbursement Accounts are a patent-protected product. Claim cost and frequency may vary by group. Charges and fees may vary by group. This is not an illustration or a formal quote. Ask your broker for a formal quote.