Frequently Asked Questions

A Health Reimbursement Account (HRA) is a tax-advantage Plan benefit that allows you to pay for a wide range of medical expenses considered to be qualified under IRS Section 213 of the Internal Revenue Code, including self-payment premiums to the Health and Benefit Plan, using accumulated credits.

The Board of Trustees have chosen Create as the market leader in consumer directed healthcare benefit accounts, to assist the Plan in providing participants with 24/7 access to the allowances within their HRA’s.

The HRA is a benefit of the Lake County Indiana NECA – I.B.E.W. Health and Benefit Plan. Eligible employees and participants can accumulate HRA benefit credits to receive reimbursement for qualified, medical, dental, vision and Rx expenses.

Further, and for the reason that the HRA is a benefit, it is the Board of Trustees that determines the scope of how it is set up and used – including the allowance you and each employee will receive

Access to your account is only a few clicks away at mycreatehealth.com or through their app.

Didn’t download the app yet? What are you waiting for? Go to your app store. Type the word “MyCreateHealth” into the search function and follow the instructions to download.

For first time users, the following login instructions will work for either the app or website portal. Or if you prefer, you can view a site tutorial by copying and then pasting within your browser the link directly below:

HRA accounts are credited at the same frequency in which your eligibility is credited. Meaning: the amount of excess contributions earned in a work quarter will be tallied and subsequently credited to an employee’s HRA account during the corresponding quarter of coverage.

Please note that the middle column is deliberately left blank to emphasize the fact that there exists an administrative “lag quarter” that separates a work quarter from its corresponding quarter of coverage. Meaning: Excess contributions in any work quarter do not get credited in the subsequent calendar quarter of coverage. Rather, it skips a quarter.

The initial balance of your HRA account is calculated by tallying the total amount of employer contributions in excess of 450 that are received on your behalf within the first calendar quarter AFTER obtaining initial eligibility or reinstatement of eligibility and multiplying that number by the “value” of each hour contributed. That amount is then credited to your HRA account in the quarter of coverage that corresponds to the work quarter in which the excess was earned.

After your account is established, the total amount of employer contributions submitted on your behalf in each subsequent and successive calendar quarters will be tallied. If you worked greater than four hundred and fifty hours (450) during the previous fiscal quarter, the hourly rate or value of those “excess” hours will be credited to your HRA. The crediting of your HRA account will occur in the quarter of coverage that corresponds with the work quarter in which the excess of contributions occurred.

Active employees can amass a total balance of $17,000.00 within their HRA’s. Retired participants can amass $25,000.00.

You can use HRA monies to make self-payments, but the Plan does not permit the use of HRA allowances to make COBRA payments.

Provided you utilize the HRA allowance for an eligible expense, reimbursements made from the HRA are not considered part of your income and are not taxed.

With the exception of COBRA payments and those expenses that are reimbursable by any other source such as another insurance company, the Board of Trustees have permitted all other qualified expenses as described under Section 213 of the Internal Revenue Code. This would include, but is not limited to deductibles, coinsurance costs, prescription drugs or other types of out-of-pocket costs. Please check the Health and Benefit Plan’s Summary Plan Description Book for exact details of what the HRA will reimburse for and what it will not.

Immediately.

Reimbursement requests that exceed your account balance will be reimbursed up to the amount available in the account. Please remember that services must have been rendered before they will be reimbursed. If you spend all of your HRA benefit allowance and still have an amount you owe, you will need to bridge that gap with money out-of-pocket.

Yes. Throughout the year, you need to keep your original receipts and documentation for prescriptions and health related expenses for all transactions (including debit card transactions), so you’ll have them if needed to verify a claim. The IRS requires that all transactions are validated, including the debit card transactions.

In most cases involving debit card transactions, the electronic data that the Plan or its third-party administrators have will be sufficient to accommodate this requirement. If the Plan or its third-party administrator does not have the electronic data or if the transaction cannot be validated, you will be contacted, and you’ll be asked to provide documentation with receipts. Make sure you respond promptly to any request for receipts. Failure to do so can result in:

1. The expense being labeled as ‘ineligible,’ in which case you would be obligated to reimburse your HRA.
2. The temporary deactivation, and if proper documentation is not received within sixty calendar days, the permanent deactivation of your debit card.
3. The amount of the non-qualified expense being reported to the IRS as deferred compensation, making those funds taxable.

In most circumstances, you will not need to submit a manual request for reimbursement. If the situation arises, requests can be made using an HRA Reimbursement Claim Form. This form is available on the Plan’s website or by calling 219-940-6181. Completed reimbursement requests should be mailed to:

Create

PO Box 161357

Altamonte Springs, FL 32716.

Or you can fax the completed form to the following toll-free number: 844-791-8317.

For faster processing, you may upload completed forms and documentation on the create portal or mobile application.

Generally, you have 365 days from the service date to submit a claim for consideration for reimbursement. However, should you be terminated from the Lake County Indiana NECA – I.B.E.W. Health and Benefit Plan, your debit card will be deactivated upon termination and you will be provided sixty (60) calendar days to manually submit any claims for consideration for reimbursement.

The HRA debit MasterCard allows users to access the their HRA credit without having to complete and file forms. Participants are permitted to use the card whenever they incur an eligible and definitively known out-of-pocket expense. The latter of which is identified within the explanation of benefits the participant received for medical and dental expenses.

Pursuant to IRS mandates, HRA benefit credits can only be utilized for remaining eligible expenses AFTER the insurance provider, this Plan, makes its payment or adjudicates for co-payments, coinsurance, deductibles etc.

As such, known expenses are those that are identified within this Funds medical and dental explanation of benefits (EOB’s) as the participants responsibility.

Stated slightly differently, participants are advised that they are not to utilize their debit card for medical, dental or visions expenses PRIOR to the claim being adjudicated by the Plan

IRS regulations require you to immediately repay the amount back to the Plan if you have “mistakenly” used your debit card to pay for an expense prior to the Plan adjudicating that claim or claims.

In addition, the Plan requires that full remuneration is to occur within sixty days (60) from the date of the transaction. Should payment not be received within the sixty (60) day period, the amount of the disbursement will be reported to the Internal Revenue Service as deferred compensation, making those monies taxable, and your debit card will be permanently deactivated.

Further, and for the reasons that both the HRA provisions of this Plan and the Internal Revenue Service’s regulations are well documented and explained, the Plan will neither:

1. Wait for the participant to first get reimbursement from the provider before they repay their HRA account; nor,
2. Adjudicate the claim and apply any Fund payment as an accumulated HRA credit.
3. Entertain the periodic repayment of that obligation, nor,
4. Obtain, chase down, get a hold of, or find a provider’s bill or claim nor intercede in any way with the participants provider because the participant is unwilling and/or has a general malaise toward taking personal responsibility for incorrectly utilizing the HRA debit card.

Your account can be used for eligible medical expenses only, and you are responsible for reimbursing your account if the card is used either accidentally or intentionally for an ineligible expense.

When this occurs, either the Plan or its designated representative will notify you within the HRA transaction portal of any ineligible purchases that are made with your debit card or for that matter, of any submission requiring further documentation, substantiation or your attention.

Should this occur, you will be required to pay back the money to the Plan within sixty (60) calendar days. During that time period your card will be temporarily disabled. Should you fail to make the payment within the sixty (60) day repayment period, the amount of the disbursement will be reported to the Internal Revenue Service as deferred compensation, making those monies taxable, and your debit card will be permanently deactivated.

Consequently, if you utilized the HRA debit card to pay for an ineligible expense and failed to timely reimburse the Plan for said purchase, you must report it in your annual income tax filing and pay the related income taxes and applicable IRS tax penalty, if any.

While you can use your debit card to pay for some over-the counter medicines, please keep in mind that you may be asked to submit receipts and documentation for these purchases. The IRS has changed the law to cover some over-the-counter drugs, including antacids, allergy medicines, pain relievers and cold medicines. For the exact list of what is covered, visit www.irs.gov.

The card will be declined if ‘swiped’ for more than your available balance. Simply ask your provider to ‘swipe’ the card for your available balance and pay the difference out-of-pocket. Another option would be to pay the amount yourself and submit a reimbursement request with your receipt to the address provided on the claim reimbursement form.

You can still use the card to pay the bill by writing your debit card number on the invoice and mailing it in, or by providing the card information over the phone to the physician’s office.

After the debit card is ‘swiped,’ the system verifies that adequate funds are available in your account, and that the expense is from a qualified merchant. If these checks hold true, the funds are then deducted automatically from your account. If these checks prove negative, the transaction is denied. If the transaction is denied, then another method of payment must be used.

You are provided a debit card with your name personalized on it. Only the individual whose name is on the card can use the card when making a health care-related purchase, but the purchase can be for any dependent covered under the Lake County Indiana NECA – I.B.E.W. Health and Benefit Plan at the time services were rendered.

No. The card only allows processing of health care expenses reimbursed through the Lake County Indiana, NECA – I.B.E.W. Health and Benefit Plan and only accepts transactions using providers of authorized services.

No. The HRA is not portable. Meaning; you cannot take it with you.

Participants who find themselves in this situation will have sixty (60) days from the date of termination to manually submit out-of-pocket expenses that were incurred while they were covered under the Plan. After sixty (60) days, any remaining balances within a participants HRA account will be forfeited

No. As stated within the Plan’s Summary Plan Description Book (also found within this website) the HRA benefit is funded solely by employer contributions.

Really?

You’re kidding right?

Someone please queue up Billy Preston’s seminal 1974 hit “Nothing from Nothing” while we open some eyes here. “Eh-hem,” simply put, once any HRA benefit credit is depleted, you are responsible for paying for any additional out-of-pocket costs out of your own monies.

Provided you are doing unit work covered under an IBEW collective bargaining agreement, and AFTER you accumulate HRA benefit credits, the card will again be available for you to use, or you can electronically or manually submit claims for reimbursement once again.

If your card is lost or stolen, report it as soon as possible by contacting the Health and Benefit Fund Office at 219-940-6181. There is a five dollar and two cent ($5.02) replacement fee that must be satisfied prior to a new card being issued. Please be advised that the replacement fee cannot be debited directly from your HRA account and must be made directly to the Fund Office by check.

Yes. If:

1. Your provider or merchant does not accept MasterCard debit cards.
2. You choose not to use your debit card.
3. Your debit card was temporarily deactivated, or
4. Permanently turned off.

Simply pay for your expenses and either submit a request for reimbursement electronically or manually submit a reimbursement claim form along with the receipt for the eligible expense(s) to Create.

If your coverage terminates, the following will occur:

1. Eligibility for dental, health, HRA, life-insurance, pharmaceutical, and vision benefits cease for you and any eligible dependents.
2. Your HRA (Create) debit card is deactivated, and you will have sixty-days days to manually submit claims for reimbursement that were incurred within three hundred and sixty-five days preceding the termination from the Plan.
3. Regardless of subsequent reinstatement, after sixty-days any balance within your HRA account will be forfeited. Meaning; the HRA allowance does not travel with you. As stated directly above, you will have a limited time period of sixty-days to submit additional requests for reimbursement of qualified medical expenses incurred while you were covered under the Plan, and, at the end of that period, the account balance will be forfeited.

No. As stated within the Plan’s Summary Plan Description Book (also found within this website) the HRA benefit is funded solely by employer contributions.

Yes.

YES! You must do so “even” for debit card transactions.

On that note, all participants are reminded that if the Plan or its designated third-party administrator believes that further substantiation is warranted, the participant MUST present the corresponding receipt. Failure to do so may result in the transaction being cancelled, and/or repayment to the Plan by the participant, permanent deactivation of the participants HRA debit card and a tax obligation for the participant.

Participants who have issues with this and wish to argue their position that either their submission or they are special and warrant an exemption or that it wasn’t their fault, may do so with the Internal Revenue Service.

Three things:

1. At first, your HRA debit card will be temporarily deactivated. You will have sixty calendar days from the date of the notice to submit the requested proper supporting documentation.
2. Should you fail to submit the proper supporting documentation during that sixty-day time span, your HRA debit card will be permanently turned off. And,
3. The amount of the unsubstantiated disbursement will be reported to the IRS as deferred compensation, making those funds taxable.

No.

Well, we are sorry to disappoint you, but that is not going to happen.

First, the Plan has not only disclosed that the use of a debit card is not a right under the Plan, but it also has disclosed the importance of keeping your receipts, and what would occur if you do not submit them in a timely manner when requested.

Secondly, the Plan has to treat participants equally without favoritism or discrimination. Simply put, reactivating your card would be providing you a benefit not afforded to other participants. Equally important, doing so would incur another expense to the Plan. That expense would be on top of the expense the Plan incurred when:

1. It had to subsequently issue the request for documentation after identifying the infraction,
2. It had to then track that request. And if not received or received timely,
3. It had to file said infraction with the Internal Revenue Service,
4. It had to issue the appropriate tax form to the member.
5. It had to spend considerable amount of time on the phone with an angry participant because said participant failed to read any or all notices concerning the keeping and timely submission of receipts and/or the misuse of their HRA card. Such communications would include, but are not limited to:
• The warning on the paper to which the debit cards were adhered to when originally issued,
• The following newsletters:
1. June 8th, 2020, announcement letters,
2. The Summer of 2020 newsletter,
3. The Spring of 2021 newsletter,
4. The Summer of 2021 newsletter,
5. The Fall of 2021 newsletter,
6. March 2022 newsletter,
7. November 2022 newsletter,
8. September 2023 newsletter,
9. December 2023 newsletter,
10. January 2024 newsletter,
11. April 2024 newsletter,
12. July 2024 newsletter,
13. September 2024 newsletter,
• The HRA provision within the Health and Benefit Plans Summary Plan Description book,
• The HRA landing page on the Funds website,
• The HRA FAQ’s
• The notice requesting the submission of receipts that are provided to participants within the create portal if they fail to provide proper supporting documentation.
• At several monthly membership meetings since 2021 through the present.
• Before eighty percent (80%) of the monthly membership meetings since 2021 by the Fund Manager.
6. It had to listen to all the reasons why the deactivation was not the participants fault and/or how the participants do not think it is fair or why they should be the exception to the rule.

Thirdly, fairness is defined as being in accordance with rules or guidelines. In accordance with that definition participants are kindly reminded that their HRA debit card was deactivated or permanently turned off for the reasons that they have broken a rule and guideline. With that said, participants are informed that even though they loss the convenience of a debit card, they still have access to their HRA credits via electronic submissions or manual submissions through the U.S. Postal Service.

Lastly, permanently means “perpetually,” or “for good.” It does not mean “episodic,” “temporary,” or “fugacious.” Capiche?

First, remember that there are only four reasons that would cause deactivation to occur. Either:

• The participants chose not to rectify their improper use of the card at all, or,
• The participants chose not to address the matter in a timely manner, or,
• The participant chose not to address the matter with sufficient action or documentation in a timely manner in order to thwart the permanent deactivation of their card.
• The participant lost coverage under the Plan.

Secondly, reread those four points and keep in mind the old adage …., “If the shoe fits…., wear it!”

Thirdly, keep in mind that the HRA debit card is a relatively new feature of this benefit. Meaning; prior to its introduction a few short years ago, the only way to receive this benefit was to submit a manual claim. Stated more concisely, you survived without the debit card prior, and we are relatively certain you will again.

Fourthly, take the following action:

1. Click on the following link: https://www.merriam-webster.com/dictionary/permanently
2. Decide if you are going to submit future reimbursement requests electronically through the portal or app, or manually by completing the reimbursement form and submitting it along with your receipts into Create.

Fifth, and as stated in previous communications on this matter, recognize that the deactivation of your debit card does not mean that you no longer have access to this benefit. You still do and as described directly above you can receive the benefit through electronically filing a claim or manually filing the claim.

Sixth, admittance is the first step, or so they say. So come to the realization that it happened and then get on with your life.

Lastly, you can always write an appeal. That is your right. If you elect to do this, it helps if your written request lists all the facts, dates, names and any other information you think is pertinent to support your argument that you were neither involved in whole nor in part in the card’s deactivation.

By the way, and not unsimilar to the proper usage of the HRA debit card, the appeal process is also clearly delineated within the Plan’s Summary Plan Description (SPD) Book. A copy of which has been conveniently placed within this very website, under the Healthcare tab.

If, due to a shortage of hours, you are in danger of losing your eligibility under the Plan and have an HRA benefit balance in an amount greater than the quarterly total of your shortage of hours, your HRA benefit balance will be automatically debited to be used to coverer the full quarterly shortage of hours so that you and your family maintain eligibility with the Plan.

The day and time that a participants HRA benefit balance will be automatically debited is solely determined by the Plan and will vary as needed to ensure that the Participants shortage of hours payment arrives on or before its due date. Further, the Plan’s automatic debit will supersede any other pending debit or HRA request.