Active Plan HRA
Your SASMI benefits include a Healthcare Reimbursement Account (HRA) for eligible active members. It’s fully funded by employer contributions, and those dollars can be used to help pay for allowable over-the-counter medical items. So, get your HRA debit card and get ready to save!
Important Note for Participants in Locals 4, 5, 15, 48, 54, 67, 85, 177, 214, 399, 435 or the employees of CI Metal Fabrication
You will not be able to receive an HRA debit card, but you can still use your HRA funds.
How Your HRA Is Funded
If you’re eligible, SASMI will set up and maintain an HRA for you as an active member. To open an HRA, you must have enough employer contributions from the previous year to fund your account with a minimum of 250 credits. Note that each credit is equal to $1. Your account will be funded each July with a percentage of the previous year’s employer contributions.
If you don’t need to use your reimbursement now, your HRA balance is there for you later. Your HRA is funded each year and can accumulate as long as you meet eligibility requirements. There is no use-it-or-lose-it rule. At retirement, any balance remaining in your active plan HRA rolls into your retiree HCRA.
For Example
Sam had $6,000 in employer contributions in 2022. For his initial HRA balance, he’ll have 1,200 credits allocated or a $1,200 opening balance. (That’s 20% of $6,000.)
He’s eligible for all SASMI benefits and registers on the member portal to get his HRA Card.
He uses $200 of the HRA balance on eligible expenses between July 2023 and June 2024 reducing his balance to 1,000 credits.
In both 2023 and 2024, he has the same employer contributions as in 2022 (total of $12,000) for a (total Active Plan HRA contributions of 3,600 credits). He claims $300 worth of eligible expenses during each following July to June for a total of $600 in claimed expenses.
He retires October 2025 with 35 future service credits.
- Total lifetime contributions = $100,000.
- He took $20,000 in other active benefits (travel, unemployment, etc.).
Sam’s HCRA Calculation at Retirement
- $100,000 x 150% = $150,000
- – $20,000 in other benefits
- – $3,600 for Active Plan HRA allocations
- = $126,400
To which is added:
- $12,000 service-based HCRA (if qualified)
- +$3,000 remaining in his active HRA
Total starting HCRA balance at retirement = $141,400
Using Your HRA
You can use the HRA to pay for eligible expenses for yourself and your dependents covered by your SMART health plan. You can also use your HRA funds to purchase allowed everyday health items from a retail pharmacy or any eligible online FSA/HSA/HRA vendor, like the FSA store. Here’s a sample of what’s eligible:
- Prescription drugs
- First-aid supplies
- Aspirin, fever, and pain relievers
- Antacids
- Allergy and sinus medications and sprays
- Smoking cessation products
- Cold and cough medicine
- Hearing aids
The SASMI HRA Debit Card
To get an HRA debit card, you must first register for your card on the member portal. About two weeks after you register for a card, you will receive it from WEX, our HRA partner. Once you receive your card, activate it and start using it to pay for medications and allowable health items at a drug store or grocery store pharmacy counter, or online at the FSA Store at fsastore.com. Note that a regular grocery or pharmacy checkout counter will not accept the card.
Where You Can Use the Card
You can use the card at:
- Pharmacy counter of pharmacy
- Pharmacy counter of grocery store
- Online at FSAstore.com
You cannot use the card at:
- Regular register or checkout at the pharmacy
- Regular register or checkout at the grocery store
- A store that does not accept debit cards and does not sell qualifying items
If You Are Not Able to Get a SASMI HRA Debit Card
If you are a participant in Locals 5, 15, 54, 67, 85,214, 399, 435 or an employee of CI Metal Fabrication, you will not be able to receive an HRA debit card, but you can still use your HRA funds.
Why Am I Not able to Get an HRA Card?
Certain members have prescription drug coverage that presents a claims-processing technological complication. This prevents these participants from being able to use the HRA debit card.
What Do I Do Instead?
The good news is 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/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.
Spending Your HRA Dollars
Although most online pharmacies will allow purchases with your HRA debit card, the FSA Store is SASMI’s approved online merchant. You can shop for over-the-counter meds online and generally, the items sold there are preapproved to use with an HRA. The FSA Store lets you set up automatic renewals and shipping for items you use often. Just provide your HRA card information and let your HRA pay for your health items.
If you’re not sure whether an item is eligible, use the SASMI/HCRA mobile app to scan the item to confirm before making a purchase.
Managing Your Account
Access to your account is available 24/7 by using the SASMI/HCRA mobile app or by calling SASMI and opting into the HRA Help Line at 800-858-0354. You’ll be able to:
- View (or hear) your account balance
- Review debit card transactions (if applicable)
- Request a new card if you lose it (if applicable)
HRA Frequently Asked Questions
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.
How Is My Active Plan HRA Funded?
On or about July 1 of each year, credits are 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 is accessible to eligible members through a debit card administered by WEX, which eligible participants can use to pay for covered medical expenses. IMPORTANT: The debit card won’t automatically be sent to you. You must visit the member portal and register for it. 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.
Which 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.
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.
What Happens if My HRA Balance Drops to $0?
There is no need to maintain a certain amount in the HRA. If your account balance drops to $0, your account will be inactive 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.
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, 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.
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.
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.