What is the new SASMI Active Plan benefit?
Starting July 2023, the SASMI Active Plan will include an HRA (Healthcare Reimbursement Account) for eligible participants. Note that owners are not eligible to participate (for details, see Active Plan Definitions and Article II, Section 5 of the Active Plan).
What is the SASMI Active Plan HRA?
The SASMI Active Plan HRA is an account that eligible members can use for reimbursement of certain medical expenses. It is funded with distributions from SASMI, based on the employer contributions received by SASMI. The Active Plan HRA is considered a “limited HRA,” which means that SASMI chooses the expenses that are eligible. Only prescription drugs and allowable over-the-counter medical items can be purchased through the Active Plan HRA.
When is my Active Plan HRA first available to me?
For your Active Plan HRA to become available:
- You must have a total of at least 250 credits (currently $1 = 1 credit) allocated to you; and
- You must be eligible for SASMI benefits, not have lost eligibility under the plan, not have terminated participation, and not have lost qualification for benefits. For details, see Active Plan Article II and Article XII. Also refer to additional FAQs, below.
How will my Active Plan HRA be funded?
On or about July 1 of each year, credits will be added to your Active Plan HRA, based on the contributions SASMI receives for work you performed in the prior calendar year. Credits are determined in an amount equal to 20% of the contributions received by SASMI, and each credit is worth one dollar. For example, Sam had $6,000 in contributions in 2022. Around July 1, 2023, he will have 1,200 credits (worth $1,200) added to his Active Plan HRA.
How do I access the HRA?
The Active Plan HRA will be accessible to eligible members through a debit card administered by WEX, which eligible participants can use to pay for covered medical expenses. (If you are a member of a local where the HRA debit card is unavailable, see the question below).
What do I need to do to start using the HRA?
IMPORTANT: The debit card won’t automatically be sent to you. You must visit the member portal and register for it.
- Go to sasmi.org > Member Portal Login to get your card.
- Once you receive the debit card from WEX, the Active Plan HRA administrator, activate it and then you can start using it.
What happens if I lose my card?
Call the SASMI HRA Help Line at 800-858-0354 to request a replacement card.
What members can’t get a HRA debit card?
If you are a participant in the Sheet Metal Workers National Health Fund (Locals 5, 54, 67, 214, 399, 435) the employees of CI Metal Fabrication, or Locals 85 and 15, an HRA debit card is unavailable to you.
Can I still use the HRA if an HRA debit card is unavailable to me?
Yes! You can still use the HRA for your prescription and allowed over-the-counter expenses:
- Pay for your prescriptions as you currently do and submit your claim to your insurance carrier. When you receive your Explanation of Benefits (EOB), use the SASMI/WEX HCRA mobile app to upload the EOB so that you can receive reimbursement.
- If you shop for eligible over-the-counter items, you’ll need to upload your itemized receipt through the app to receive reimbursement.
Download the SASMI / HCRA app on the App Store or Google Play and use it to manage your HRA and get reimbursed.
What types of expenses are covered?
The Active Plan HRA can be used to pay for prescription medication and allowable over-the-counter (OTC) items such as pain relievers, antacids, allergy and sinus medications, and first-aid supplies, at the pharmacy counter of your local drug store or grocery store. The HRA can also be used to purchase eligible items from a participating online FSA vendor. Currently, SASMI partners with the FSA Store at fsastore.com.
Can I use the HRA to pay for doctor visit copays or a dental or vision exam?
No. The SASMI HRA is considered a “limited HRA.” This means that only certain expenses are eligible: prescription drugs and allowable over-the-counter medical items.
What are examples of ineligible HRA expenses?
Examples of ineligible items include diapers, hand lotion, cosmetics, general dental products such as standard toothpaste, general daily vitamins, and dietary supplements without a doctor’s note.
Can I use my funds for my family members’ expenses?
Yes. You can use these funds to pay for prescription drugs and allowable over-the-counter medical items for you, your spouse, and your eligible dependents if they are covered under your SMART Health Plan.
After I begin using my HRA, are there any ongoing eligibility requirements to meet?
Yes. You must be eligible for SASMI benefits and not have terminated participation. If you lose eligibility, then your HRA debit card will temporarily be unavailable for use until you regain eligibility. See FAQ 10–16 for how the HRA debit card could be suspended or forfeited. (For details, see Active Plan Article II and Article XII, and additional FAQs below).
Note: You will not lose the ability to use your HRA card simply because you are ineligible for other benefits under the 200% rule or because you are ineligible for supplemental unemployment or underemployment benefits based on a failure to work 10% of the applicable group hours.
If my credit balance drops below $250, can I continue to use my HRA debit card?
Yes. Your HRA needs to be at 250 credits for the account to become available the first time. After that, unless your account is suspended or forfeited you can continue to use the balance in your account. See additional FAQs below for more info.
What happens if my HRA balance drops to $0?
No need to maintain a certain amount in the HRA. If your account balance drops to $0, your account will be inactivated until the next July credit allocation, when your card will be reactivated and ready to use.
Is there anything else that can cause my HRA card to be suspended or inactivated?
Yes. Firstly, if you lose eligibility in your local SMART Group Health and Welfare Plan, your Active Plan HRA will be suspended. Secondly, SASMI pays a monthly fee for each card. If there is no activity on your card for 12 consecutive months, your card will be inactivated and you will be notified. You can call 800-858-0354 to get your card reactivated.
If my card is suspended or inactivated, will I get future allocations?
Yes. Each July, if you are eligible, an allocation will be made to your Active Plan HRA whether you have activated your HRA card or your HRA card has been suspended for inactivity. All allocated credits will remain available until used unless forfeited or otherwise lost (see FAQ 14–16 below).
Can I lose (forfeit) my Active Plan HRA benefit?
Yes. As with all SASMI Active Plan benefits, your Active Plan HRA can be forfeited if you lose eligibility, terminate participation, or lose qualification for benefits (as stated in the Active Plan), including if:
- You accept any employment in the sheet metal industry from an employer who is not party to a collective bargaining agreement with the international union or a local union;
- Your home local union takes an action that terminates or will at some future date terminate the provisions of the local union’s contracts; or
- You permanently cease employment in the sheet metal industry, accept permanent employment outside the sheet metal industry, whether or not you remain in your home local union, or become a partner or the sole proprietor of a business in the sheet metal industry.
If you transfer to a local union with no contracts or one with a contract only requiring contributions to HCRA-B, you will lose access to your Active Plan HRA. However, the remaining balance will be added to your Retiree HCRA at retirement if you are eligible. (See Active Plan Article XII(b)(2).)
What happens to my Active Plan HRA if I die?
If you have surviving dependents who were covered by your local SMART welfare plan, they can continue to use your Active Plan HRA as long as they remain covered. Your Active Plan HRA account balance will be forfeited if you die while an active participant and you don’t have any surviving dependents covered under your SMART welfare plan immediately prior to your death.
What else could cause me to lose my Active Plan HRA?
Like all SASMI benefits, the Active Plan HRA is not a vested benefit and, while the Trustees don’t anticipate this happening, they can at any time discontinue the benefit or modify the value of the credits (currently $1 per credit) in your account.
Can I choose to let my Active Plan HRA account “grow” without using it?
Yes. You are not required to take the steps to get your HRA card nor are you required to use the benefit if you do have the card. There is currently no limitation on how large the account can grow. See the question below for what happens if you have an Active Plan HRA balance at retirement. Also, see the FAQ on information about forfeitures and how the value of the credits in your account can change.
Is the allocation to my Active Plan HRA treated as an active benefit?
Yes. When the Active Plan HRA allocation is made each July, the calculation of your active benefits taken will be increased by the amount of the HRA allocation for purposes of the 200% rule (100% if you have more than $125,000 in contributions). The allocations will also be counted as active benefits when your severance (if applicable) and retiree HCRA are calculated.
If I don’t use all of my Active Plan HRA, what happens to the balance?
Any Active Plan HRA balance remaining when you retire will continue to be available to you and your eligible dependents. The amounts from your Active Plan HRA, your retiree HCRA, and, if applicable, your service-based HCRA will all appear as a single account.