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HRA Account: How to Submit Claims

Publications
HRA Information Packet (PDF) Direct Deposit Authorization (PDF) HRA Claim Form (PDF)

The HRA is a reimbursement account that allows for reimbursement of eligible medical, dental, and vision expenses. Participants may use the HRA debit/VISA card for point-of-service expenses; however, there will likely be times when expenses are paid by personal check, cash or directly from a personal account or a social security check. When this occurs, a claim must be submitted to Nyhart in order to receive a reimbursement from the account. Each expense claim must be accompanied by substantiation of that expense.

Reimbursements

To receive a reimbursement a Direct Deposit Authorization form(PDF) needs to be completed and sent to Nyhart. This will allow Nyhart to send all the claim reimbursements directly to a bank account through an electronic funds transfer.

Reimbursements will only be paid from the HRA account up to the amount accumulated in the account at the time the claim is submitted. If there are more expenses in one year than is available in the HRA account, the Participant can get reimbursed for the remaining expenses in the following year once Indiana University credits the account again. Nyhart will automatically issue reimbursement payments, once there are additional funds in the HRA account, for prior claims that could not be fully reimbursed.

Nyhart will provide the reimbursement for the claim as soon as administratively possible after the claim has been submitted.

Claims for expenses incurred while participating in the plan can be submitted for reimbursement at any time while still participating in the plan. At the close of the five year term for the ERIP-2013 HRA plan there will be an additional 90 days to submit final claims for reimbursement for services incurred during the five year term. At the close of the 90 days (claim deadline) any remaining balance in the HRA is forfeited.

Submitting Claims by Mail or Fax

Collect the receipts for expenses that were paid for out-of-pocket while participating in the ERIP-2013 plan and print the HRA Claim Form (PDF). 

Complete the form by providing Name, Employee ID, Address, Dependent Information (if the expense is for them), the Type of Expense, Date Incurred and the Amount. Multiple expenses can be listed on one claim form.

Send the HRA Claim Form and the supporting documents to Nyhart by:

Submitting Claims Online

To submit claim information online, go to iutsb.nyhart.com. Login and select: ‘Submit Claim’. In order to substantiate claims online it is necessary to have a digital file of the supporting documentation to attach to each expense item. 

Please do not send the same claim by multiple methods. 

Supporting Documentation for Expense Claims

For each expense in a claim for reimbursement a supporting document must be included.  Supporting Documents (claim substantiation) can be in the form of:

Each supporting document must include the following:

Be sure to retain a copy of the Claim and the supporting documentation.

Substantiation for Recurring Monthly Payments

ERIP-2013 Participants will only have to submit supporting documentation for their monthly recurring expense (such as monthly COBRA premiums, Medicare payments, Supplemental Medicare Plan payments, etc.), once per year.  Reimbursement for these recurring payments is not automatic; a claim form must be submitted with substantiation and a request to set up “recurring reimbursements”.  Nyhart can then set this up for you.

Expenses cannot be reimbursed prior to the date for which the expense is actually incurred and services rendered.  For example, if insurance payments are made six months in advance, reimbursement can only be released each month for the current month. One Claim can be submitted for the entire six month period and Nyhart will automatically release the funds as the appropriate month approaches.

If at any time premium costs change or the Participant decides to cancel the existing substantiation for a recurrent claim, notify Nyhart immediately. It is necessary to provide updated supporting documentation to reestablish the substantiation for a recurring monthly claim.

Please note:

Claims cannot be reimbursed if the expense was incurred prior to the date participation began. Claims for expenses incurred while participating in the plan can be submitted for reimbursement at any time while still participating in the plan. However, claims will only be paid from the HRA account up to the amount accumulated in the account at the time the claim is submitted. If there are more expenses in one year than is available in the HRA account, the Participant can get reimbursed for the remaining expenses in the following year once Indiana University credits the account again. Nyhart will automatically issue reimbursement payments, once there are additional funds in the HRA account for prior claims that could not be fully reimbursed.

At the close of the five year term for the ERIP-2013 HRA plan there will be an additional 90 days to submit final claims for reimbursement for services incurred during the five year term. At the close of the 90 days (claim deadline) any remaining balance in the HRA is forfeited.


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