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
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.
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.
To submit a claim, 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 you file a claim or use your SASMI Debit Card for an amount that is higher than your HCRA balance, you’ll only be reimbursed up to your HCRA balance.
You cannot submit a claim more than two years from the date of the service or the expense.
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.
What’s my SASMI benefit?
Log in to the member portal to keep track of your SASMI activity.
SASMI made 12,377 payments to 5,716 individual members in the amount of $20,473,192. The average turn around time between application and receipt of payment was 12 days.
“Without the help of SASMI, my family and I wouldn’t have been able to keep our health insurance when I wasn’t able to work. We needed the help; my wife was expecting our second child at the time. Thank you, SASMI!”
– Jake Smith
Hear what your fellow members have to say about SASMI.