Health Care Reimbursement Account (HCRA)

Most members know SASMI for its assistance during their careers, but SASMI is also “there for you later” — as in, during your retirement.

When you retire from the industry, you may be eligible for a Health Care Reimbursement Account (HCRA) through SASMI. The HCRA is funded with any unused employer contributions that were received on your behalf during your time as an eligible active member.

A HCRA can give you an extra source of income to pay for eligible health care expenses for yourself and your family.

You can use your HCRA to receive reimbursement for qualifying health care expenses that you, your spouse or other dependents (up to age 27) 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.

You can pay for expenses using your SASMI debit card or apply for reimbursement through the SASMI HCRA mobile app or by filing a claim. You can manage your account through the app or check your account information through the WEX portal.

Reimbursements are deposited to your bank account tax free.

Eligibility

To qualify for the HCRA benefit, you must:

• Stop work with all SASMI employers on or after January 1, 2010;
• Be eligible for and receiving a pension from the Sheet Metal Workers National Pension Fund or another SMART local union pension fund; and
• Have at least two years of future service credit.

I’m Ready to Retire. What Do I Need to Do?

When you retire or leave covered employment, log into the member portal to apply for your HCRA using the Separation Application. Once completed, print it, sign it in pen, and submit it to your local. 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.

Estimating Your HCRA Benefit

You can estimate your HCRA benefit based on your current status. Note that it cannot be fully calculated until you retire and are eligible for benefits. To estimate its current value, watch this 60-second video [link coming soon] or follow the steps below:

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).

You can check your HCRA balance anytime through the member portal, the WEX portal, or the SASMI/HCRA app. Keep in mind that your estimate is subject to change both from contributions received by your employer and the SASMI benefits you use, if any.

What Types of Expenses Are Eligible for Reimbursement Through the HCRA?

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.

You can 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.

The HCRA can only be used for eligible health care expenses. For a complete list of eligible expenses, visit https://www.irs.gov/pub/irs-pdf/p502.pdf. NOTE: The SASMI Trustees have excluded expenses related to the construction industry.

What Is WEX?

About two weeks after you apply for your HCRA, you will receive a SASMI debit card for your HCRA from WEX, our HCRA partner. WEX assists in processing both our HCRA and Active Plan HRA claims. You can login to the WEX portal any time to check on your latest balance, see recent purchases, or check the status of a claim.

If You’re Having Trouble Accessing the WEX Portal
If you’ve been locked out or can’t remember your username or password to the WEX portal, you can click “forgot username” or “forgot password” on the main screen and follow the instructions.  If you are unable to log in, feel free to contact SASMI via email at [email protected] or by calling 703-739-7250. Or, if you’re using the right username and password, it may mean that your information is incomplete. For example, you may be missing some important information, like your email address, date of birth, IA and/or initiation date.

Getting Reimbursed

Using the SASMI Debit Card

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

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

Because you are only permitted to use your debit card for eligible expenses, the SASMI Fund Office needs to substantiate each expense you submit. When you pay for an eligible expense with your debit card, it’s easy. Just take a photo of your itemized receipt, and then go to the SASMI HCRA app, find your claim, and upload the photo.

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

If You Do Not Use the Debit Card

Using the Member Portal
If you do not use your debit card to pay for your expense, complete a claim form, available on the member portal, and attach an itemized invoice from the provider. It must be itemized so that it is clear that the reimbursement you are seeking is for an eligible expense.

Using the SASMI HCRA App
If you paid for a service with your own money (you didn’t use the debit card), you can still 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.

Other Types of HCRAs

Service-Based 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.