Health Reimbursement Accounts (HRA) Health Reimbursement Accounts help you control the benefits you fund to provide long-term incentives for a member’s wise use of medical care dollars. Last modified: 9/27/11 © 2011 United HealthCare Services, Inc.

HRA key features Employer contributions Annual lump sum, pro-rated Account rollover Percent, flat, capped amounts Incentive contributions Stored separately with rollover dollars Covered services Deductible, coinsurance, copay, all 213(d) Initial deductibles Individual, family Claim auto-reimbursement HRA/FSA combination Account stacking or HRA then FSA UMR’s HRA offering is an integrated design that uses the same claim engine to process HRA claims alongside major medical coverage. Plan members receive a single explanation of benefits and physicians receive a single claim payment. No separate claim submission is required. Our design is flexible, giving employers the option to keep current deductibles in front of the HRA and determine the dollar amounts for deductibles and HRA contributions. Last modified: 9/27/11 © 2011 United HealthCare Services, Inc.

An HRA example Last modified: 9/27/11 HRAs have a straight-forward process. Employers pay 100 percent of all preventive care coverage. Then, the employer determines an amount (in this example it’s $500) to deposit into the employee’s HRA account. The employer also determines the annual amount employees must pay out of pocket. That combination of funds add to the overall deductible. The deductible can be structured just as it is shown here or an employer can place the HRA deductible in front of the patient responsibility. Once the deductible is met, a high-deductible health plan adds another layer of protection for additional medical expenses, with co-insurance. Unlike an FSA, any unused HRA dollars can be carried forward from year to year. The dollars carried forward can be capped according to employer specifications. Should an employee leave the organization, any unused HRA dollars will remain with the employer. Last modified: 9/27/11 © 2011 United HealthCare Services, Inc.

Using incentives with HRAs Purpose: Build health awareness and achieve behavioral change Details: Available to both employee and spouse No point system – dollar amounts only Customer specific incentive programs Even with an HRA, you may still struggle to engage employees. Every employer struggles with how to gain employee attention. Studies have shown that people spend just a little more time selecting a health plan than they do buying a pair of shoes. To be effective, CDHPs need to engage members. UMR offers a number of incentive programs that can be used individually or as a package. Our flexible options allow you to design a strategy that works for your unique situation. Each incentive is deposited in an HRA to pay any covered out-of-pocket expense of a plan member. Spouses can earn the same incentive as employees, an important point since spouses can be the decision maker for the family’s health care choices. The educational tutorial and quiz informs members how the plan works Web-based; must meet timeframe, Web quiz The Coverage Advisor assists the member in choosing the best plan option Prior to enrollment, complete use of WebMD Web tools The Clinical Health Risk Assessment helps the member understand their health status and provides valuable information to the disease managers as they focus their efforts on high-risk individuals who are open to change Must meet timeframe, Web- driven, or paper Last modified: 8/16/11 © 2011 United HealthCare Services, Inc.

Using an HRA and FSA together UMR is all about integration. We’ve created a program that allows members to use their FSA in conjunction with their HRA to fund deductible expenses not covered by the HRA. Last modified: 9/27/11 © 2011 United HealthCare Services, Inc.

HRA pharmacy only debit card About the debit card: Convenient alternative for members to access HRA funds when pharmacy is integrated with medical Program partnership with 11 outside PBMs including: Prescription Solutions Express Scripts (Medco) A convenient alternative for members to access HRA funds when pharmacy is integrated with medical is the debit card. UMR offers this through our partnership with Evolutions1. Evolutions1 has existing partnerships with 11 PBMs, including Prescription Solutions, Express Scripts and Medco. You do need to use one of Evolutions1’s PBM partners because real-time auto-substantiation is required for pharmacy expenses under the HRA. Because double payment could occur, the debit card cannot be used with auto-reimbursement to pay the provider for the same product. UMR also needs to receive eligibility by Dec. 1 to assure your members have the debit card in hand by Jan. 1. Last modified: 8/16/11 © 2011 United HealthCare Services, Inc.