Member
Here are answers to the most common questions about COBRA.
- What is COBRA coverage?
- The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a continuation of group health plan coverage for a qualified individual who might otherwise lose coverage under a group health plan.
- How do I get on COBRA?
- COBRA has basic requirements to be eligible. An eligible qualified beneficiary (QB) is one who loses group health plan coverage due to a qualifying event. The QB may elect to continue group health plan coverage for a limited time on a self pay basis.
- What are Qualifying Events?
- A Qualifying Event (QE) is generally when a triggering event causes a loss of health plan coverage. There are 7 triggering events:
- Termination of Employment or Reduction in hours.
- Birth or adoption
- Death
- Marriage or Divorce
- Child gains or loses dependent status
- Gains or loses Medicare or Medicaid coverage
- Qualifying Medical Child Support Order
The qualifying event must cause the QB to lose coverage.
- A Qualifying Event (QE) is generally when a triggering event causes a loss of health plan coverage. There are 7 triggering events:
- How long can I stay on COBRA?
- COBRA requires that continuation coverage extend from the date of the qualifying event for a limited period of 18 or 36 months. The length of time depends on the type of qualifying event that gave rise to the COBRA rights. A plan, however, may provide longer periods of coverage beyond the maximum period required by law.
- Can a family member or friend call and ask questions for me?
- BMA follows and adheres to HIPAA regulations and we will not be able to talk to anyone regarding your account unless they are an adult on the account or we receive written permission from you that we are allowed to release information to that named person.
FSA Questions
What is a Health Flexible Spending Account?
A healthcare flexible spending account (FSA) is an employer-sponsored benefit that allows you to set aside pre-tax dollars into an account to be used for eligible medical, dental and vision expenses for you, your spouse, and your eligible dependents.
Is a Healthcare FSA the same thing as a Dependent Care FSA?
No.
A Healthcare FSA is set up to help you pay healthcare expenses for you and your dependents. A Dependent Care FSA is to help you pay for childcare and elder care expenses so you can continue to work.
Why should I participate in an Flexible Spending Account?
Contributions to the FSA are deducted from your paycheck on a pre-tax basis, reducing your taxable income. You can increase your spendable income by an average of 30% of your annual contribution with the tax savings.
How does the Debit MasterCard® factor in?
By participating in the FSA plan, your group may offer a Debit MasterCard®. The debit card can be used right away for medical expenses. Simply pay for your medical expenses at the point of sale with your card. You will not be paying out-of-pocket; therefore you will no longer need to fill out manual claim forms and wait for reimbursement as described above in the traditional format!
How is a Flexible Spending Account funded?
Your annual election will be divided by the number of pay periods in your plan year. This amount will be deducted from your paycheck before taxes are assessed.
What expenses are eligible for reimbursement under a Flexible Spending Account?
You can use an FSA plan to pay for eligible health plan co-pays, deductibles, co-insurance, eyeglasses, dental care, and certain medical supplies, as outlined in your plan document. For additional information see IRS Publication 502.
You can also shop a full list of FSA-eligible items in our FSA Store.
What is a Letter of Medical Necessity?
A Letter of Medical Necessity is a letter written by your doctor, verifying that the treatment, supplies or medication you are buying with your Healthcare FSA is for a diagnosis, treatment, or prevention of a disease. This letter is required by the IRS for certain eligible expenses. Review the list of eligible expenses to see if you need a Letter of Medical Necessity for a particular type of expense.
How will I know if items are FSA-eligible?
You can use an FSA plan to pay for eligible health plan co-pays, deductibles, co-insurance, eyeglasses, dental care, and certain medical supplies, as outlined in your plan document. For additional information see IRS Publication 502.
You can shop a full list of FSA-eligible items at our FSA Store.
Does BMA have a Flexible Spending Account Mobile App?
Yes. Our FSA Mobile App is available on both Google Play and the App Store.
- To download the BMA FSA Mobile App via Google Play or App Store
- Search
BMA FSA or click the logos below
- Search
How do I know how much money to contribute to my Flexible Spending Account?
Annual contribution may not exceed $2,850 per year, as determined by the IRS. A different limit may apply to you according to your employer’s plan, refer to your plan document for specific limit amounts.
Take a look at last year’s out-of-pocket medical expenses to get the best idea. Calculate the amount of recurring medical expenses to determine what your contribution amount should be.
To estimate your annual medical costs and help determine your best contribution amount, Click Here to download BMA’s reimbursement worksheet.
BMA_FSA-Expense-Worksheet_Eng_Span_FlipHealth Reimbursement Account
What is a health reimbursement account (HRA)?
An HRA is part of your employee benefit plan. Your employer contributes money each year to help you pay for eligible healthcare products and services for you and your dependents not covered by any other source.
How is an HRA different from an FSA?
An HRA is a reimbursement account set up and funded by your employer to cover eligible healthcare expenses. Unlike a healthcare FSA where the IRS defines the eligible services, the employer defines the services eligible for reimbursement from an HRA. Typically, an employer will reimburse healthcare services like doctor’s office visits and hospital services, and prescription drugs. For details on qualified expenses for your plan, check your summary plan document. Your employer will provide you this document which details the rules of coverage.
How will I benefit from my HRA?
Employers offer an HRA in conjunction with your health insurance plan in order to help offset your out-of-pocket responsibility. Your health insurance plan may require you to pay out of your own pocket in the form of co-payments and/or a deductible before your insurance plan starts paying for services. Also, once you meet your deductible, you may need to pay a percentage (‘coinsurance’) of services until you meet your out-of-pocket maximum. An HRA helps offset your deductible and coinsurance responsibility by allowing you to pay for those costs from funds set aside by your employer. The funds your employer contributes are not included in your salary and are not considered taxable income.
How do I access my HRA funds?
If you have a benefits debit card linked to your HRA, pay with your card and qualified purchases will be automatically debited from your HRA. Some HRAs offer automatic payment of your responsibility. If your plan offers this service, your out-of-pocket expenses will automatically be paid from your HRA. Again, refer to your summary plan document to see if this service is available to you. Otherwise, you will be required to pay for the medical service upfront and then
submit for reimbursement.
How do HRAs Work?
Your health insurance plan comes with a deductible which applies to certain healthcare services. Your HRA is intended to help you pay for deductible expenses after you meet a portion of your deductible. At that point, your HRA will cover future deductible expenses with no need for you to pay out-of-pocket until your HRA is exhausted.
How do I access care with an HRA?
When you see a healthcare provider, the provider will submit a claim to your insurance plan. Some services may be covered prior to meeting your deductible, such as preventative care visits. If the service is subject to your deductible or coinsurance applies, your provider will generally bill you after the health plan has processed the claim. If you receive a bill form your provider, you pay out of pocket and then file a claim for reimbursement from your HRA (a reimbursement check will then be mailed or deposited into your bank account).
How do I get reimbursed?
Getting reimbursed for medical expenditures is fast and easy when you register your bank account to receive direct deposits. Reimbursement checks can also be mailed to you upon approval of your claim.
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