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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.

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