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If you are offering a health reimbursement arrangement for the first time, it is highly recommended you walk through your plan design with your broker or CDPHP representative. Then, use this checklist to walk you through the process of setting up your funding account.

Choose a Health Plan

An HRA can be paired with any health plan.

Design Your Service

Use the Healthy Direction Administration Agreement to walk you through the questions that will help you set up your service.

  1. Complete the required fields including contact information and the medical plan ID

  2. Choose your steps
    Choose healthy steps your employees (and their spouses or domestic partners, if applicable) will need to complete. Full step descriptions can be found on the Healthy Direction Manager flyer. Select from the following:

    • Visit a primary care physician

    • Take the Personal Health Assessment (PHA)

    • Get a biometric screening

    • Go CDPHP Smoke-Free

    • Take a free CDPHP wellness class

    • Get a Flu Shot

    • Participate in a CDPHP Workplace Health wellness program

    • Create your own activity

  3. Agree to Terms and Conditions

  4. Will there be an HRA deductible?
    You may also choose to have employees pay some out-of-pocket charges before HRA funds can be used. Important note:  If you select an HRA deductible, any money paid out of pocket for prescriptions does not automatically apply to an employee’s HRA deductible. The employee must complete an HRA claim form and submit it along with prescription receipts. This can be completed online through the secure site or via mail.

  5. 5. What percentage of each expense do you want reimbursed?
    Once you determine what you want to reimburse, you can choose to reimburse 100 percent of each purchase, which is standard, or you can choose to reimburse a lesser percentage.

  6. 6. Do you want to allow carryover of unused funds?
    You may also elect to let employees carry over all or a portion of unused funds from year to year. If you choose not to allow carry-over, a 90-day run-out period will apply in order to account for claims incurred that year.

  7. What should you offer employees who enroll off-cycle?
    This is referred to as off-cycle or the new hire allocation rule. If employees enroll after the plan effective date, you can allow them the entire year’s allocation, or you can prorate it by month. Alternately, you may also choose not to offer them any allocation until the next plan year.

  8. Example - Plan year begins 1/1/2020 and annual allocation for a single contract is $1,200. Employer selects “prorate by month” for off-cycle allocation rule and hires a new employee 4/1/2020. New hire enrolls in a single contract and will receive $900 in their HRA.

  9. Do you want to offer a debit card?
    A debit card may be available with your plan. You can decide if you want to offer it, and if you do, you can determine for which services the card can be used. Talk to your broker or CDPHP representative for guidance. Please note: If prescriptions are subject to the medical deductible, as with qualified high deductible plans, then you may want to offer a debit card for members to use prescription purchases. CDPHP medical claims integration does not apply to point-of-sale purchases at the pharmacy. In addition, if you offer an HRA and a health FSA, your employees will receive one debit card for both.

  10. If you are offering both an HRA and health FSA, choose an order rule.
    Specify which account should pay first in instances where an expense is eligible under both HRA and FSA(section 4 of the Administration Agreement). Please note: If FSA pays first (uncommon setup), employees entire annual election needs to be spent prior to employee having access to HRA funds.

Provide Bank Account Information

Capital District Physicians’ Healthcare Network, Inc.(CDPHN) needs your bank account information to retrieve the funds when employees submit claims or use the debit card for qualified expenses. In order to do this, please keep the following guidelines in mind:

  • You will need two Automated Clearing House (ACH) Authorization Forms: one for CDPHN and one for the debit card vendor. CDPHN or the debit card vendor will pull the funds directly from your bank account.

  • It is highly recommended that you use a Zero Balance Account (ZBA), a checking account in which a balance of zero is maintained by automatically transferring funds from a master account in an amount only large enough to cover checks presented.

Complete the Business Associate Contract

This is included as part of the Administration Agreement.

Complete the Enrollment Roster

Sign and Submit Documentation

Completed paperwork should be submitted by the 15th of the month prior to the plan’s effective date.

  • Employers: Provide a copy to your sales representative

  • Brokers: Upload single PDF file to iConnect or provide a signed copay to your sales representative

What Happens Next?

Sign Contracts and Adopt Plan Documents. You will be emailed Plan Document and Summary Plan Description (SPD) templates for your authorization and signature, to be completed and returned to CDPHP by your group’s effective date. It is your responsibility to then share the SPD with your employees.

By completing healthy steps, employees can earn incentives provided by you. Simply sign up for the online service, use the customizable employer toolkit to promote the program, and supply the incentive as employees complete the steps. » Learn More.

Healthy Direction

Reward employees for investing in their health while you save money on health care costs.