Health Care Reimbursement Account (HCRA)

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.

HCRA-B

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 a HCRA-B obligation.

The calculation of your HCRA takes the total contributions that your employers made on your behalf to SASMI throughout your career and multiplies those employer contributions by a percentage based on your years of future service credit and past service credit. That amount is then subtracted by any SASMI payments you may have received as an active member.

Your HCRA calculation is based on 100% of the contributions received from your employer—from day one.

If you are a retiree who was active in 2023, your initial HCRA account will be calculated like this:

• Step 1. Multiply your years of future service credit by 1.67 (0.8535/stabilization period) to get the additional multiplier %. Note that the additional multiplier is capped at 50%.
  • For Example:
    10 years of future service credit will be an additional multiplier of 16.7%
    20.5 years of future service credit will be an additional multiplier of 34.235%
    35 years of future service credit will be an additional multiplier of 50%
• Step 2. Add the additional multiplier % to the starting 100% of contributions to get the final multiplier.
  • For Example:
    10 years of future service credit has a multiplier of 16.7% and a final multiplier of 116.7%
    20.5 years of future service credit has a multiplier of 34.235% and a final multiplier of 134.235%
    35 years of future service credit has a multiplier of 50% and a final multiplier of 150%
• Step 3. Multiply the total contributions (minus contributions to HCRA Plan B) by the final multiplier.
• Step 4. Subtract any active benefits you’ve been paid (excluding non-deduct benefits).

When you retire or leave covered employment, log into the member portal for the HCRA application. Then, complete it and submit it to the SASMI Fund Office. Don’t apply until your separation or retirement date, but you must apply before the April 1 after you reach age 70½.

Plan to allow a minimum of three 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.

Retirees must meet certain eligibility requirements to be eligible. SASMI Trustees reserve the right to change or end retiree benefits at any time.

About two weeks after you apply for your HCRA, you will receive a SASMI debit card for your HCRA from WEX, our HCRA partner. Review this debit card FAQ for details about the card.

Once you receive your card, activate it and start using it to pay for eligible health care expenses.

Be sure to save a copy of your receipt because you’ll need to submit it as proof of your expense. You have two ways to submit your receipt:

1. Upload your itemized receipt to the SASMI app:
   • Go to Tasks and select Action Required to approve your claim.
   • Tap on the claim requiring a receipt, take a photo of it, then upload it, and tap Submit; or

2. Complete a claim form and attach an itemized invoice from the provider. Follow the instructions on the form for how to submit it.

If you lose your card or need more cards, make your request through the member portal or the HCRA app.

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. This list of covered expenses is a brief overview of expenses eligible for reimbursement through the HCRA.

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.

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.

Use the SASMI HCRA App

Watch this video for details on how to use the app.

If you paid for a service with your own money (you didn’t use the debit card), you can file a claim on the app:

1. On the SASMI HCRA app, tap File a Claim and Select if it is a medical or premium claim and enter the claim information.
2. Tap Upload Receipt to take a photo of your itemized receipt. Make sure your name, payment amount, date of service and the name of provider are clear in the photo. If you do not have a paper receipt, take a screen shot of your email receipt and upload it from your photos.
3. Tap Submit to finish.

Reimbursement will be made to your bank account on file with the SASMI Fund Office.

Submit a Claim Form

Complete and submit this form. Itemize your expenses with date, name of patient, provider, service received 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.