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Healthy Blue PPO HRASM – features

Healthy Blue PPO HRA has numerous features designed to provide you with options. The following is a basic list of those features:


  • Specified expenses: You determine which IRS publication 502 medical expenses are covered by the HRA, and whether or not the HRA pays for in-network expenses only. In addition, you may cap the total HRA account balance. Specified expenses encourage thoughtful management of HRA funds by employees.
  • Spend or save mode: You determine if the account is in save mode (reimbursement occurs only when a manual claim is filed or a debit card is used) or spend mode (claims are paid by automatic reimbursement based on information received from the PPO plan.)
  • Debit card: Employees use special debit cards to pay for qualified expenses. The account must be in save mode (see above). The debit card is not available if the HRA only pays for health-plan-covered expenses.
    • If you offer stacked accounts, employees access all accounts from their debit cards based on the reimbursement order you establish.
    • You can provide a restricted debit card (used for pharmacy and over-the-counter medications, pharmacy only or medical copayments only).
  • Proration: You can prorate (per month) a portion of the benefit year to reflect a newly hired employee's benefit.
  • Online account information: Employees may check available HRA balances, recent transactions and year-to-date information. Employees may also call the toll-free number on the back of their Blue ID card to get this information.
  • Rollover options: You can allow remaining HRA funds to roll over to the next year's HRA. In addition, a retirement rollover option sets aside funds that are inaccessible until employees retire.
  • Extended claims filing: You set a specified time (30, 60, 90, 120 or 365 days) following the end of calendar year that claims for services provided that year may still be submitted for payment.
  • COBRA funds distribution: If employees purchase COBRA continuation coverage, they retain access to their HRAs and health plans linked to them. As long as COBRA premiums are paid, employees are entitled to their HRA balances with the same annual employer contribution as active employees.
  • Incentives: This is a contribution-based HRA that rewards employees for meeting specific health and wellness criteria (e.g., completing health assessments, smoking cessation programs, etc.)
  • Pay the provider: With this option, the Blues pay health care providers directly from employee HRA accounts. This eliminates additional paperwork and ensures prompt payment of health care providers.
  • Employee pays first: An employee must pay an amount you specify before using any HRA funds.