A Better Way to HRA: Complex Accounts Made Easy (and More Profitable!)

The IRS allows unique flexibility for health reimbursement arrangements (HRAs), giving employers creative ways to reduce overall healthcare spend and tax liability while offering competitive benefits to their workforces.

Complex HRAs—the most highly tailored solutions—layer additional rules on top of a standard HRA, for example:

• Behavior changes once an employee meets the deductible or retires
• Percent reimbursement per account type or across different tiers
• Copays for specific services, like prescriptions
• Variables by health plan option, like employee only vs family coverage

But this inherent flexibility makes it difficult for administrators—like TPAs, financial institutions, PEOs, and health plans—to administer complex HRAs without dedicating significant staff time or outsourced program budget to plan setup and ongoing maintenance. Even worse, some administrators must deny new clients looking for complex plans or force clients to choose from a menu of pre-set hardcoded options.

‍Why is it so difficult? Currently, most platform solutions place a significant burden on administrators to manage HRA rules. And many administrators solve this problem by creating multiple HRAs for each scenario and relying on convoluted, often manual, enrollment logic outside of the HRA system. ‍

There’s a better way.

Elevate removes the administrator burden with a one-two technology punch: an attribute-based plan setup tool combined with a configurable, rules-based payment engine.‍

Elevate simplifies even the most complex plan set ups into an easy, repeatable process. Plans are up and running in minutes—no development or implementation required.

The Magic of a Simplified Plan Creator

Elevate simplifies plan creation with a unique attribute-based plan setup tool. This allows even the most complex HRA plan rules to be easily configured within the intuitive online tool—in minutes. Administrators are given full access to this tool, with no development or ticketing required. For administrators, this is a complete game changer, simplifying initial setup, enrollment, renewals, and even plan modifications.

A few examples of configurable rules include:

• Deductible thresholds triggering account activation and payment status
• Out-of-pocket payment settings
• Payout amount settings aligned with plan tiers‍

There’s more. Built into this plan creator are plan templates. We affectionately refer to these as an administrator’s silver bullet. It allows administrators to instantly recreate pre-set plans and further customize the rules for other employer clients—saving tedious (and often error-prone) administrative hours.‍

And there’s even more. Because of Elevate’s built-in system hierarchy, plan rules can be set at any level—even the sub-plan level. This means unlimited plan variations across employers, allowing ultimate flexibility and accuracy with minimum manual processes.‍

Complex HRAs in Action: Rules-Based Payment Engine

Layered on top of the plan creation tool is a rules-based payment engine. Once a complex HRA is set up, the system automatically tracks each member indivually and applies payment rules tailored to that specific person, according to their employer’s plan.

‍Let’s break this down with an example. Let’s say an HRA plan should only begin paying out after a member reaches their coverage-level deductible, and it should only pay out at 80%. This type of complex plan design previously required manual processing on traditional platforms (or was simply not allowed at all). But with Elevate’s rules-based payment engine, the system automatically does not provide reimbursements before the deductible is met, then reimburses at 80% after the deductible is met—all hands-free, all in compliance with that employer’s plan rules, and all based on each member’s individual status.  

Even better, members easily move from dormant to active status automatically, eliminating manual enrollment steps.

And what about the other 20% the member owes? Because Elevate has a comprehensive, all-in-one platform, the member can choose to pay that out-of-pocket amount from another account, a health savings account (HSA) or flexible spending account (FSA). Other market solutions cannot offer this level of coordination and member convenience.‍

Not Just HRAs

While we are focusing on HRAs in this article, Elevate’s comprehensive platform supports multiple account types in the same manner, including HSAs, FSAs, limited-purpose plans, lifestyle plans, and more. This “all-in-one” model provides the added payoff of simplification and automation for all the ways accounts can function when combined.

For example, in an FSA/HSA combo, a limited-purpose FSA may convert to a general-purpose FSA once the deductible is met. Traditional solutions often require the FSAs to be set up as two different account types with manual transferring of enrollment. With Elevate, there is one account that automatically converts to new payment rules based on the member’s status.

Real-Life Game Changer

This smart tech combination can transform the way administrators are able to react to massive external regulatory impacts. In recent years, the industry has had to react to COVID-19-related regulations and guidance impacting FSA and HRA plan flexibility, deadlines, rollover rules, and waivers. HSAs were impacted by delayed tax filing dates. While these changes were burdensome for most administrators, Elevate’s system allows administrators access to make plan modifications quickly and easily in the plan setup tool and populate throughout all plan levels. ‍

Bringing it All Together

For administrators, this unique tech combination solves a myriad of problems while delivering improved outcomes. In a nutshell, the game changers provided by Elevate are:

• Templates are self-contained, reuseable, and have rules embedded.
  The payoff: No external resources are required to build, select, or modify plan templates.‍
• New groups are set up by selecting pre-built templates; additional customization is enabled by overriding specific rules when needed.
  The payoff: No more tickets to build a custom plan. No more being able to offer only certain plans based on existing templates. No more saying no to clients looking for complex plans.‍
• Elevate changes account behavior automatically based on tracked data and pre-defined account rules.
  The payoff: No more errors, no more manual processes.‍
• Renewals are hands off.
  The payoff: No more Q4 rush, more time for teams to focus on what matters.‍

A Modern, Smarter Solution

The bottom line? Elevate’s groundbreaking HRA platform empowers administrators to deliver a modern HRA solution that aligns with the demands of their clients…all the benefits without all the complexity.‍

• ‍Burden shift: The Elevate platform automatically manages the rules and behavior of complex plans, removing administrative time, tasks, or outsourced expenses.  ‍
• Scalability: Setups, adjustments, and renewals become a non-event, allowing more clients to be serviced at scale.‍
• Error reduction: Manual, tedious, and error-prone steps are automated, eliminating the chance of human error.‍
• Market expansion: Administrators can easily bring on new clients with complex plan needs, like retiree populations, union populations, and even clients with complex account pairing requests.‍
• Cost containment: Because all plan setups can be done in-house by account administrators, there are no implementation or development costs or timelines.

Interested in learning more? Let’s get talking.