Unused contributions from your time as an active member do not disappear when you stop working. You can use them to help cover your out-of-pocket medical expenses as a retiree with a Health Care Reimbursement Account (HCRA).
What Is a HCRA?
A HCRA is SASMI’s current retiree benefit, and is available to eligible members who retire from work in the sheet metal industry on or after January 1, 2010. It’s funded through employer contributions to SASMI for the hours you work in covered employment.
You can use your HCRA to receive reimbursement for qualifying health care expenses that you, your spouse or other dependents incur. Expenses may include deductibles, copayments, coinsurance or even premiums you pay to a health insurance carrier or to the SMWIA local union welfare fund. Check this list to see what qualifies as an eligible medical expense.
When you apply for a reimbursement, the money you receive is tax-free and is deposited directly to your bank account; or you can use your SASMI Debit Card at the point of service. For quick and easy reimbursement, use the SASMI HCRA app, available for free download.
When you retire or leave covered employment, complete this application and submit it to the SASMI Fund Office. Don’t apply until your separation/retirement , but you must apply before the April 1 after you reach age 70½.
Plan to allow a minimum of three (3) months after your retirement date and your initial application before you can submit a claim for reimbursement or access your SASMI Debit Card. You will not be able to receive reimbursements or use your SASMI Debit Card before your retirement or before you are approved for this benefit.
That depends. The amount is a percentage of the total contributions that your employer(s) made on your behalf to SASMI throughout your career, minus any payments you may have received from SASMI as an active member. That percentage varies depending on the years of service worked in the industry. If you haven’t received any payments, your HCRA may have up to 150% of the total contributions made on your behalf!
You can check your HCRA balance anytime through the member portal.
Use the funds in your HCRA to reimburse eligible health care expenses that you, your spouse, and your dependent children incur. Expenses from your non-disabled dependent child may be incurred until the end of the year (December 31) in which your child turns 27.
Expenses eligible for reimbursement are those that are not covered or reimbursed in full by a health plan or insurance policy. Expenses must be for “medical care” as defined under Section 213 of the Internal Revenue Code, such as plan deductibles, copayments, and other non-covered expenses for medical, prescription drug, dental, vision, hearing care and mental health services. You can even search for eligible over-the-counter items by scanning them with your phone. Just download the SASMI HCRA app to your smartphone to get started.
A HCRA may also be used to pay for self-pay premiums, other medical plan coverage, Medicare supplemental coverage, Medicare Part B or D monthly payments, and long-term care insurance premiums (but not life insurance premiums), subject to approval by the Trustees.
For details on what is eligible for reimbursement, go to irs.gov and search for Publication 502. This list of covered expenses is a brief overview of expenses eligible for reimbursement through the HCRA.
Once your application has been submitted and your account is set up, you can begin using your HCRA to reimburse yourself. Using your HCRA is easy, especially if you use the SASMI HCRA Smartphone app.
Using the App to file a new claim
To file a new claim when you did not use your debit card:
Tap “File a Claim” from the App’s main menu.
Select whether it is a Medical or Premium claim
Enter the information for the claim.
Take a photo of your itemized receipt and by tapping the “Upload Receipt” camera icon. Make sure your name, payment amount, date of service and the name of provider are all clear in the photo.
If you do not have a paper receipt, and it was sent to you via email, take a screen shot and upload the receipt from your photos.
Tap the “Submit” button to finish. The App will let you know that your claim has been successfully filed.
Reimbursement will be directly deposited to the bank account you have on file with the SASMI Fund Office.
Using the App to substantiate an existing claim
To provide proof of payment when you did use your SASMI debit card to pay for an item or service:
On the Mobile App home screen under “Tasks”, tap “Action Required” to approve your claim.
Tap on the claim requiring a receipt and use your camera to photograph and upload it.
Submitting a paper claim form
To submit a claim without the app, complete this form and itemize your expenses with date, name of patient, name of provider, service provided and amount, and attach an itemized invoice from the provider. Note that canceled checks or receipts that do not list recipient’s name, date, name of provider and service are not acceptable; or use your SASMI Debit Card.
If your collective bargaining agreement contains an obligation to contribute to HCRA-B but not to SASMI, you will not be eligible for SASMI Active Benefits, like unemployment or underemployment.
Your HCRA-B functions just like the regular HCRA benefit, but your balance will be equal to your contributions and compounded interest credits made by your employer on your behalf during your career.
Some local union collective bargaining agreements contain both a SASMI and HCRA-B obligation.
Service-Based Health Care Reimbursement Account (HCRA)
If you retired on or after January 1, 2010, you may have a service-based HCRA. This benefit replaced the retiree health premium benefit and gave eligible members a single benefit of $12,000 as a deposit into a HCRA administered by SASMI. To find out more about the service-based HCRA, refer to your Summary Plan Description.
Using the HCRA App
Watch this video to learn how to make filing a HCRA claim quick and easy.
Visit the Apple Store or Google Play app stores to download the SASMI HCRA app to your mobile device for free. It makes filing claims and keeping track of your HCRA balance a breeze. Learn more here.
“As time flew by, the funds added up. SASMI helped us through some lean times in the past, and now as retirees, we have a 130.5% return on our investment in our HCRA account, combined with $12,000.00 from our Service Based HCRA, all TAX FREE! The funds can be used for anything medical, which is now easier with the debit cards we were issued.”
– Hugh H. (Tommy) Robertson, Jr.
Hear what your fellow members have to say about SASMI.