What is a Scheduled HRA?

A Scheduled Health Reimbursement Arrangement (HRA) benefit plan is an employer-funded benefit that is designed to look like a traditional benefit plan with underlying deductibles, co-insurance and co-payments.

Navia offers three different Scheduled HRA plans to provide employers with the best option to meet their company’s needs – Scheduled Medical HRA Plans, Scheduled Dental HRA Plans, and Scheduled Vision HRA Plans.

Employers can specify which expenses are eligible for reimbursement through the HRA and whether or not those expenses are subject to deductibles, co-insurance and/or copayment provisions.  Most plans require a claim to be allowed by the high deductible health insurance plan in order to qualify for the employer’s HRA.  Many plans utilize co-pays, co-insurance, and deductibles to aid in controlling costs and utilization. Most of our medical plans require a claim to be allowed by the high deductible health insurance plan to qualify for the employer’s HRA.

Self-Funded Dental & Vision

For Scheduled HRA dental/vision plans, these are not partnered with an insured benefit plan. Dental and vision plans are designed the same as the medical with optional deductibles, copayments and limitations for services.

With our Scheduled HRA Dental and Vision plans, employers completely fund all dental and vision claims for their employees.  However, they have the freedom to design and tailor the benefit plan to what fits their company’s needs the best. Most employers design their plan to include a share of costs arrangement with their employees.

Share of Costs – A share of costs is a concept that allows employers to make employees financially responsible for a portion of their benefit plan.  For example, if the benefit amount per employee is $100, your client could design a share of cost plan of 50/50, where they would pay 50% of the $100 and their employee would pay 50% of the $100. That means they would both owe $50.  Employers can also require the employees to pay a monthly “premium” towards the costs as well.

Self-funded dental and vision plans allow an employer to only pay for claims that are actually incurred. Under traditional fully insured dental and vision plans, an employer must pay premiums for a participating employee even if they do not use the plan. These plans can implement claims being paid based on Usual, Customary and Reasonable (UCR) fees. Under this scenario, the benefits paid will be restricted to a certain UCR percentile chosen by you. This protects you from paying claims to providers whose fees are higher than UCR.

Dental Networks

With our dental plans, we offer several different networks to choose from to give your employees a bigger discount when seeing a contracted dental provider. Below are the networks you can choose from:

Vision Network

With our vision plans, we do not offer a network. The participants will receive an ASi/Navia Benefit ID Card and they can go to any provider to receive vision services. Some vision providers choose to require payment up front for services, which means your employees will have to pay out-of-pocket upfront and then submit an itemized statement to ASi/Navia for reimbursement.

Participant Features

  • Online or mobile HRA claims submission
  • Dedicated HRA service team to handle complex HRA questions
  • Mobile app
  • Direct deposit for claims reimbursement
  • Customer service online, by email, or by toll-free call

Employer Features

  • Configurable support for popular HRA plan types
  • Comprehensive enrollment and communication assistance
  • Online and mobile app account access
  • Dedicated Schedule HRA support team
  • Plans comparable or equivalent to traditional benefit plans
  • Plan document and Summary Plan preparation

Open Enrollment Support

Navia’s clients who participate in our OE webinars see an average 6% increase in enrollment, and clients who participate in our email campaign see an average 15% increase!

Check out our Navia Benefits Academy for our robust open enrollment program to help increase your enrollment year over year!

Interested in learning more?

Contact our sales team at 425.452.3498 or sales@naviabenefits.com

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For Individuals

Scheduled Health Reimbursement Arrangements (HRA)
Reduce your out-of-pocket healthcare expenses

What is a Scheduled HRA?

A Scheduled Health Reimbursement Arrangement (HRA) is a plan that can integrate with an employer provided group medical insurance plan (your primary insurance carrier), or a dental or vision benefit plan.  A Scheduled HRA is set up and funded by your employer to reimburse you or your provider for qualified healthcare expenses.

Who and What is Covered?

A Scheduled HRA typically covers eligible out-of-pocket healthcare expenses incurred by you and/or your covered dependents. However, since Scheduled HRA plans are customizable by your employer, the design for each plan is endless.   

Eligible expenses are determined by your employer, but often follow eligible expenses covered by your group health plan.

In order to determine who and what services are eligible for coverage/payment, please refer to your plan’s Schedule of Benefits.

How Does it Work?

  • Enroll in a group health plan. During your open enrollment select a group health plan with your employer. If the group health plan you have selected has an HRA plan, you will automatically be enrolled in the HRA.
  • Learn about your specific plan. Since each HRA plan is different, you will need to make sure you know your plan details. You will receive a Summary of Benefits. This will be your guide to all of your plan specifics.
  • Funds are available immediately. The HRA funds are available to you on the first day of the plan year. However, you must meet the specific plan design.
  • See provider for services. Give your provider both your group coverage plan card and your ASi/Navia benefit ID card. Once you’ve received healthcare services from a provider, they will bill your medical insurance. You will receive an Explanation of Benefits (EOB) from your medical insurance provider showing how your benefits were applied. Your provider may then bill ASi/Navia as your secondary insurance. You should also submit that EOB to ASi/Navia.
  • Submit claims online! Claims can be submitted online on the ASi Gateway participant portal or through the ASi Gateway mobile app. You will need a copy of your Explanation of Benefits (EOB) when sending your claim to ASi/Navia.

Accessing Your Benefits

ASi Gateway Participant Portal

Get 24/7 access to your benefits with the ASi Gateway Participant Portal. Submit claims, view account balances and history, get alerts and notifications, and much more!

ASi Gateway Mobile App

Whether you’re at the doctor’s office or on vacation, the ASi Gateway Mobile app allows you to manage and access your benefits right from your smartphone! Available for iPhone and Android devices, the mobile app is a free-to-download and free-to-use tool for any Scheduled HRA participant.

Dental Networks

With our dental plans, we offer several different networks to choose from to give your employees a bigger discount when seeing a contracted dental provider. Below are the networks you can choose from:

Vision Benefit Card

With our vision plans, we do not offer a network. You will receive an ASi/Navia Benefit ID Card and can go to any provider to receive vision services. Some vision providers choose to require payment up front for services, which means you will have to pay out-of-pocket upfront and then submit an itemized statement to ASi/Navia for reimbursement.

Questions?

Call us at 866-777-1320 and ask to speak to a SPS representative.