Health Reimbursement Arrangement
As the Benefits Administration world becomes more complex, PowerFlex strives
to keep the TPAs job easy. Our Advanced Plans / HRA module manages all of the complexities that
have been introduced over the past years.
- Coverage Tiers: Create an unlimited number of coverage tiers for each Plan, for example Employee Only, Employee + 1, and Family. For each tier assign:
- Employer Contribution
- Employer Contribution Calendar
- Deductible Configuration
- Individual Limit
- Deductibles: Create as many deductible configurations as you need.
- Each can contain up to five tiers specifying a dollar range of claims ($0.00 to $1000.00, $1000.01 to $3000.00, etc) and the responsible party definition for each (Plan or Participant).
- Service Categories: Define an unlimited number of Service Categories (Dental and Vision, for example). For each define:
- Maximum transaction amount.
- Annual limit.
- Reimbursement percentage, or per transaction co-pay.
In addition to using these powerful structures, you may also need to
assign other components on a plan by plan basis:
- Assign deductibles by Plan, Coverage Tier, or Individual.
- Assign individual (per family member) deductibles.
- Assign max family out of pocket amount.
- Assign employer contribution by Plan, Coverage Tier, or Individual.
- Assign individual (per family member) limits based on Plan or Coverage Tier.