2. Employers are constantly battling the
burden of ever-increasing health care
expenses and contingent liabilities on
their group members. The Health
Matching Reimbursement Account
(HMRA) cost-containment program
represents the missing piece in group
plan design for employers to not only
contain their health care cost increases
but to actually experience dramatic
savings over time.
HMRA®
Is Employee Health
Coverage With Employer
Savings That Build Every Year
Find Your Way To Lower Health
Care Costs With The HMRA
®
I. The Employer’s HRA: HMRA Is The Ideal
Funding Mechanism For HRA, HSA,
HMA™
And Wellness Programs 3
II. Sample HMRA Group Member
Account Balance Growth 4
III. How The HMRA Works In Four Easy Steps 5
IV. HMRA Contribution Levels Per
Employee Or Family Per Month 6
V. The Ideal Gap Plan Alternative Or
Complement 7
No Disruption To Group Plan Design 7
VI. Employers Can Now Reduce Both Their
Fixed and Variable Health Care Costs 8
VII. HMRA Fits Into Both Self-Funded And
Fully-Insured Employer Plan Designs 9
VIII. Understanding How The HMRA Saves
Employers Money Is As Easy As 1-2-3 10
IX. Additional Discounts For Pharmacy
And Telemedicine Are Included With
HMRA 11
How Does An Employer Get Started
Saving Money With The HMRA Program? 11
X. Offer The HMADebit Card To Your
Employees And Reduce Their Medical
Expenses With No Cost To You 12
XI. About Us 13
XII. HMRA Frequently Asked Questions 14
TABLE OF CONTENTS
Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
3. The Health Matching Reimbursement Account (HMRA) is an IRS Section
105 Product that is an ERISA (Employee Retirement Income Security Act)
and HIPAA (Health Insurance Portability and Accountability Act of 1996)
compliant, medical reimbursement account program. The HMRA program
serves as a health care funding mechanism for employers that consists
of a monthly, employer contribution on behalf of their participating group
members. This monthly, employer contribution is fully tax deductible as a
business expense and is allocated towards participating group members
into their respective, individual or family HMRA account balances to
reimburse employers on their first-dollar, employee medical expenses.
The HMRA is a patent-protected product offered exclusively by National
Prosperity Health Matching Services, Inc. The HMRA is “The Employer’s
HRA” because it is a medical reimbursement account program that is
owned by the employer with all of the reimbursements flowing directly
back to the company as opposed to a traditional HRA where the employer
reimburses their employees instead.
The HMRA functions as a cost-containment tool and funding mechanism
that reimburses employers on the first-dollar of employee health care
expenses regardless of cost sharing when group members incur medical
claims. It is the ideal complement to any employer’s HRA program because
the HMRA reimbursements can be used tax free to fund employee
HRA, HSA and wellness incentive programs as well as any Section 105
medical expenses. In addition, the individual version of a Health Matching
Reimbursement Account for employees, which is a medical savings
account known as the HMA, can also be funded tax-free by the employer
for their employees through their HMRA reimbursements. (See Page 12).
The HMRA benefits allocated from each employer contribution are
credited towards separated, member account balances. These individual
or family HMRA balances are awarded a medical benefit crediting that
grows every month following each employer contribution. Employers will
receive up to $3 or more in benefits to be used as medical reserves inside
of their group members’ HMRA accounts for every $1 contributed as the
program progresses.
The Employer’s HRA:
HMRA®
Is The Ideal Funding Mechanism For HRA,
HSA, HMA™
And Wellness Programs
3
Summary Of HMRA Advantages
Savings - Employers receive
additional, first-dollar medical
benefits on their employees above
and beyond what they contribute
into the program, and these medical
reserves grow every month to
help lower both fixed and variable
health care costs as well as reduce
contingent liabilities.
Tax Advantages - The HMRA
monthly contribution is tax
deductible. Group member claim
reimbursements to the employer
are received tax free and
reimbursements can be used tax
free to help fund employee HRA,
HSA, HMA and wellness incentive
programs as well as to reimburse
group members on any Section 105
medical expenses.
Substantial Account Crediting -
Employers will receive up to $3 in
benefits to be allocated as medical
reserves for every $1 contributed
into the program as it progresses.
Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
4. TOTAL PAID
$132
MONTH 1
$264
MONTH 2
$1,584
MONTH 12
$3,168
MONTH 24
$4,620
MONTH 35
CLAIM AMOUNT
$4,600
Account Balances Permitted To Carry Over Year-To-Year
No Further Individual Member Contributions (Only
Administrative Fees Are Required) By The Employer
Once Balance Reaches Target Account Balance Cap.
* Sample administrative fees included in monthly contribution
The employer’s monthly, HMRA contribution is allocated
towards account balances for all of their participating group
members. The HMRA program reimburses employers in full
for all first-dollar, member medical claims, irrespective of
cost sharing, up to the member or family’s HMRA account
balance at the time of the claim. These member account
balances receive an increased account crediting each
month and are allowed to carry over year-to-year for the
employer. The growth of the members’ HMRA account
balances every month across the entire group serves to help
pre-fund member claims and reduce contingent liabilities
by increasing an employer’s medical reserves for each
participating group member or family.
The employer HMRA contribution is immediately tax
deductible, and the HMRA reimbursements will be
received tax free by the employer after a member files a
claim for a qualifying medical expense. The HMRA serves
to save employers money on the members’ actual claims
themselves. Through this pre-funding of claims with the
HMRA, the employer will be saving up to 30% or more on
their most frequent, first or second-dollar, member claim
obligations when they happen, and these savings occur
post-claim adjudication. The savings through the HMRA
program are earned above and beyond what the employer
contributes.
The employer is receiving additional reimbursement funds
tax free that would not have been possible without the
HMRA that they can use to reimburse directly back to their
employees tax free for any Section 105 medical expenses
or to fund employee HSA, wellness incentive programs or
the HMA (See Page 12). This is because of the rapid growth
of the employer’s HMRA medical reserves on their group
members that will serve to greatly reduce an employer’s
contingent liabilities.
Sample HMRA®
Group Member Account Balance Growth
4
When a claim is filed, the claim amount is
subtracted from the Group Member’s current
HMRA account balance. The following month’s
Employer contribution will be used to rebuild the
Member’s balance back up to the target, paid-up
cap.
Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
HMRA 10000 Level Illustrated
5. The employer is the owner of the HMRA program and makes
a defined, monthly contribution to build the medical reserve
account balances for each participating group member
or family. This contribution is immediately tax deductible.
The HMRA pre-funds employee claims ahead of time into
reimbursement accounts that earn a medical benefit crediting
that grows with each monthly, employer contribution.
With this pre-funding of claims through the HMRA medical
reserves, the employer will be saving up to 30% or more on
their most frequent, first-dollar, member claim obligations
when they happen, and these savings occur post-claim
adjudication. The employer will be receiving additional
reimbursement funds that are flowing into the company tax
free that would not have been possible without the HMRA
program in place. The HMRA medical reserves will serve
to help reduce an employer’s contingent liabilities on their
employees.
The HMRA will reimburse the full, first-dollar claim cost up to
the filing group member’s HMRA account balance at the time
of the claim back to the employer tax-free, regardless of the
existing employee cost-sharing arrangement in the plan design.
Step 1: Employer HMRA Contribution Step 3: HMRA First-Dollar Reimbursements
Step 4: Employer Earns Medical Reserves
Step 2: Employee Incurs Claim
Step 1: Employer
HMRA Contribution
Step 2: Employee
Incurs Claim
Step 3: HMRA First-Dollar
Reimbursements
Step 4: Employer Earns
Medical Reserves for:
Employee Reimbursed
HMA™
HSA HRA Wellness
Initiative
Section 105
Employee Medical Expenses
How The HMRA®
Works In Four Easy Steps
The HMRA monthly, account crediting promotes a rapid growth
of medical reserve funds available to be reimbursed tax free
to the employer when their group members incur medical
expenses.
Employers can then take these tax-free HMRA reimbursements
and use them tax free to reimburse their employees and group
members on any Section 105 medical expenses and in order to
help fund HMA, HRA, HSA or wellness incentive programs. The
HMRA is the ideal complement to any employer’s HRA program
because the HMRA reimbursements can be used tax free to
help fund the HRA program itself. The individual, voluntary
benefits version of a Health Matching Reimbursement Account
for employees, which is a medical savings account called the
HMA (See Page 12), can also be funded tax-free by the employer
for their employees through their HMRA reimbursements.
Employees can now receive enhanced benefits from the
employer through the HMRA reimbursements. It can also create
opportunities for richer, employee health plans and reduced
cost-sharing obligations because of the immense medical
reserves that employers build by implementing the HMRA
program. 5Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
6. The HMRA program can be customized for each employer
group. Employers have the ability to select different HMRA
product options for each of their group’s tiers and family
structures. Health Matching contribution levels are designed
to be flexible in order to accommodate any employer seeking
to build valuable medical reserves on their group members
to significantly reduce their health care expense obligations.
National Prosperity Health Matching Services (NPHM™)
offers a variety of levels of HMRA contribution products
per member or family per month with corresponding target
account balance caps for the employer to choose from for
their employees. These employee balances are permitted to
build up and carry over year-to-year for the employer even if
the benefits are not used.
Once employees begin to reach their target account balance
caps, the employer is no longer responsible for allocating
a portion of their monthly contribution towards that group
member’s HMRA account balance (and is only required to
pay small administrative fees on behalf of that member). This
will serve to drastically decrease the total, monthly amount
contributed towards the HMRA program while the employer
still retains all of the valuable benefits and medical reserves
that have accrued for each group member.
HMRA contribution levels can be
adjusted Per Employee or Family Per
Month to fit any Employer budget
Employers can select from
different account balance level
maximums Per Employee or Family
No further monthly, employee
contribution by employer once
Member balances reach target
account balance cap (and employer
is only required to pay small
administrative fees on behalf of the
members)
HMRA®
Contribution Levels Per Employee Or Family Per Month
HMRA 5000 $79.50 $2,782.50 $5,000
HMRA 7500 $106.00 $3,710.00 $7,500
HMRA 10000 $132.50 $4,637.50 $10,000
HMRA 15000 $190.50 $6,657.50 $15,000
HMRA 20000 $243.50 $8,522.50 $20,000
HMRA 25000 $299.50 $10,482.50 $25,000
HMRA 30000 $359.50 $12,582.50 $30,000
HMRA 40000 $479.50 $16,782.50 $40,000
HMRA 50000 $599.50 $20,982.50 $50,000
HMRA 60000 $719.50 $25,182.50 $60,000
Product Option
Monthly Cash
Contribution
35-Month Total Contribution
Per Employee Or Family
Target Account Balance Cap
Per Employee Or Family
6
Summary Of HMRA Contribution Options
* Illustration assumes no claims filed. Sample administrative fees included.
Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
7. The Ideal Gap Plan Alternative Or Complement
No Disruption To Group Plan Design
The HMRA®
is designed for employers to recognize
substantial cost reductions in the funding of employee
health expenses within a three-year period. With the
HMRA program in the fold, employers will witness
their medical reserves to pay for employee health
claims grow faster than they ever have before. The
HMRA can also serve as an attractive alternative and
complement to Gap health plans. While initially, an
employer may opt to utilize both a Gap and HMRA plan
in conjunction with one another, the need for a Gap
plan will decrease because of the rapid growth of the
employer’s HMRA medical reserves.
By implementing the Health Matching Reimbursement
Account program, employers create no disruption to
their group’s existing plan design or network coverage
expectations. The NPHM™
Services, proprietary, HMRA
software called Helix will already be seamlessly
integrated with the employer’s administrator and their
claims adjudication system to automatically issue
claims reimbursements back to the employer. The
HMRA program complements any employee cost-
sharing arrangement that is already in place. The
HMRA reimburses the employer from the first-dollar for
the full member claim amount up to that participating
member’s HMRA account balance, and this is
irrespective of the existing, employee cost-sharing
arrangement that is in place. The HMRA benefits will
be covered in the employer’s Administrative Services
Only (ASO) Agreement.
7Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
8. or large employer groups that will increase
a company’s financial strength by allowing
them to retain capital that would normally be
allocated for employee health expenses.
Employers Can Now Reduce Both Their Fixed
And Variable Health Care Costs
Sample Account Balance Growth Per Member
The revolutionary Health Matching Reimbursement
Account (HMRA®
) program reduces an employer’s costs,
risk and exposure to health claims in the most expensive
and frequent levels of claims, which is from the first
dollar. The HMRA creates additional, member claims
reimbursements flowing back to the employer tax
free that would not have been possible before. These
reimbursements serve to lower an employer’s variable
costs because the HMRA benefits will be covering
additional portions of their group members’ claim
exposure.
Furthermore, because of the wealth of reserves
accumulating in each participant’s HMRA account
balance, an employer’s fixed costs and contingent
liabilities can also be reduced because the HMRA
will allow employers the opportunity to increase their
deductibles since their HMRA reserves will be covering
an increasing portion of their first-dollar risk. The HMRA
program provides unsurpassed benefits for mid-size
Summary Of How The HMRA Lowers An
Employer’s Fixed And Variable Costs
Fixed - HMRA reimbursement benefits cover
additional
portions of employees medical expense
obligations for the employer above and beyond
what was contributed.
Variable - The growth of HMRA medical
reserves across the entire group enables
employers to increase their deductible levels
and helps to reduce an employer’s contingent
liabilities.
8
HRA, HSA
HMRA
All Scenarios Assume:
$132 Monthly Contribution
No Claims Being Filed
Administrative Fees Not Included
Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
$15,000
$12,000
$9,000
$6,000
$3,000
$0
$10,000
$5,400
$1,980
$4,752
$3,168
$1,584
Year 1 Year 2 Year 3
9. The HMRA is an ERISA (Employee Retirement Income
Security Act) and HIPAA (Health Insurance Portability
and Accountability Act of 1996) compliant, medical
reimbursement account and cost-containment program
for employers that is offered exclusively by National
Prosperity Health Matching Services, Inc. The HMRA
is also IRS Section 105 compliant and consists of a
defined, monthly, employer contribution on behalf of their
participating group members. This monthly, employer
contribution is fully tax deductible as a business expense
and is allocated towards participating group members
and families into their respective, HMRA account
balances to reimburse the employer on their employees’
first-dollar, medical expenses.
The HMRA for employers is the ultimate first-dollar,
cost-containment program that is designed to reduce
the medical expense obligations on their employees. The
HMRA program works with either self-funded or fully-
insured employers and offers benefits that will continue
to accumulate and bring down health care costs for
years to come.
The HMRA serves to help pre-fund the most expensive
portions of employers’ medical costs beneath their plan
deductibles. The HMRA program rapidly increases an
employer’s medical reserves on their group members
through the growth of individual or family HMRA
reserve account balances that are used to reimburse
the employer on their group members’ first-dollar,
medical expenses.
These reimbursements serve to reduce contingent
liabilities and provide a tax-free funding mechanism
for an employer’s HRA, HMA™
(See Page 12), HSA or
wellness programs and to reimburse employees on
Section 105 medical expenses. The HMRA also enables
fully-insured groups with the option to ease their way
into self-funding because of the wealth of medical
reserves earned inside of the HMRA program that
provides protection for the employer to guard against
future health care cost increases.
In either a fully-insured or self-funded arrangement,
the reserves building in the HMRA program can be
used to decrease employees’ cost-sharing while
simultaneously lowering employers’ fixed costs by
allowing them to increase their plan deductibles since
their HMRA medical reserve balances will have such a
large portion of the employer’s first-dollar risk to health
claims covered in either a self-funded or fully-insured
plan design. These are advantages that any employer
would be excited to secure for themselves and their
employees.
HMRA®
Fits Into Both Self-Funded And Fully-Insured
Employer Plan Designs
9Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
10. You will make a defined, monthly contribution on behalf of the group members
who you wish to participate in the HMRA program. The program is completely
customizable with different monthly contribution amounts and corresponding,
target account balance caps for each employee tier and family structure. This
contribution is immediately tax deductible instead of having to wait until the
time of the claim.
Your monthly contribution is divided into an account balance for each
participating group member or family. These accounts on your group members
are receiving first-dollar, medical benefits and crediting for each participant.
The monthly benefits being credited towards each of your group members’
account balances comes from your overall, monthly contribution, and the
HMRA account crediting grows every month. Your individual or family, HMRA
member account balances are used to reimburse YOU on each of your
participating member’s qualifying medical claims from the first dollar on ALL
OF THEIR CLAIMS EXPENSES regardless of your employees’ existing cost-
sharing arrangements.
You will receive up to $3 or more in valuable benefits and medical reserves
for every $1 that YOU contribute into the program as it progresses that will be
credited into your members’ HMRA account balances. These reimbursements
will always be received tax free and will be reimbursed directly back to
you when your employees file claims up to your members’ HMRA account
balances at the time of the claim.
You will be saving money through the reimbursements because these
HMRA first-dollar, medical reserves that are being credited to you are so
powerful that it will provide additional, tax-free funds flowing back into your
organization that would not have been possible without the HMRA in place.
The HMRA reimbursements will be covering a larger portion of the first-dollar
risk on your employees’ medical expenses and can be used tax free to help
fund your employees’ Section 105 medical expenses, HRA, HSA, HMA™
or
wellness incentive programs as well as reduce your contingent liabilities.
Understanding How The HMRA®
Saves
Employers Money Is As Easy As 1-2-3
STEP 1
STEP 2
STEP 3
10 Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
11. 11
By enrolling their groups in the HMRA program,
employers are also eligible to receive unlimited,
monthly, telemedicine access for their group
members with no copays that is already included in
their monthly contribution through various NPHM™
preferred, telemedicine partners. Each employer will
also have the opportunity to enroll in the NPHM Rx
Card Program. This exclusive, PBM (Pharmacy Benefit
Manager) program is only available by enrolling in
NPHM Services’ products and delivers significant
savings to our cardholders on prescription drugs,
diabetic care services and daily living products.
Unlike a traditional PBM discount card plan where,
in most cases, the cardholder would still be required
to pay a monthly, cardholder fee in order to receive
a discount on their pharmacy drug costs, the NPHM
Rx Card Program requires no monthly or annual fee
and secures NPHM customers much deeper cost
reductions than a conventional discount card would.
These valuable pharmacy and telemedicine savings for
the employer are an ideal complement to the HMRA
product that will already be saving the employer up
to 30% or more on average on each post-adjudicated
member claim. With the HMRA, employers can now
lower their group health care costs even further by
offering an enhanced, employee benefits package that
provides comprehensive coverage and discounts on
major-medical services.
Additional Discounts For
Pharmacy And Telemedicine
Are Included With HMRA®
Employer-Sponsored Plan (HMRA): In order to
run a customized HMRA quote and begin the HMRA
implementation process, we will need to be provided
with:
A. Fully completed HMRA Group Census File and the
HMRA (Self-Funded or Fully-Insured) Quote Form
in order to receive customized HMRA quote and
illustrations
B. Group Eligibility Claim File (To Complete HMRA
Implementation)
C. Provide Group Claims File (To Complete HMRA
Implementation)
National Prosperity Health Matching Services will
use the group eligibility and claims file every month to
process your reimbursements. Each month the employer
will receive a reimbursement check from NPHM Services
on the claims that were filed by your group members
that use the HMRA benefits. The employer can then
utilize or pass along their HMRA savings as they deem
fit, tax-free to their employees through various, medical
reimbursement programs. The HMRA benefits would be
the ideal complement funding mechanism for an HSA or
HRA plan.
Voluntary benefit (HMA™
Debit Card): If the employer
wants to offer the HMA medical savings account program
as a voluntary benefit option for their employees, it can be
made available to them at enrollment.
Once enrolled, your employees would then swipe their
HMA Debit Cards at the point of sale whether it is at a
pharmacy, doctor’s office, or hospital to pay for their
medical expenses. HMA accounts can also cover
elective procedures, home health and long-term care
expenses on a mail-in reimbursement basis. The HMA
Debit Card can be a benefit option under any plan design
or deductible option. This would be the ideal alternative
or complement to an HSA or HRA plan to assist
employees in paying for their own out-of-pocket, medical
expenses (See Page 12).
Ready-Set-Go!
How Does An Employer Get
Started Saving Money With
The HMRA?
11Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
12. 12
Offer The HMA™
Debit Card To Your Employees And Reduce
Their Medical Expenses With No Cost To You
Employers who see the value of the HMRA
®
can now offer
their employees the exact same level of benefits with the
voluntary benefit HMA Debit Card. The HMA Debit Card is
a non-qualified, accepted benefit, medical savings account
that can be used by your employees at the point of service
to cover their out-of-pocket, medical expenses including
copays and deductibles. In addition, their HMA accounts can
also be used to pay for elective procedures such as plastic
surgery, lasik, in vitro fertilization as well as long term care
and home health expenses. These elective medical expenses
can be covered on a mail-in reimbursement basis. The HMRA
and HMA programs can be adopted in tandem to help cut
down on both the employer and employees’ health care
costs simultaneously.
The HMA is often referred to as a vanishing health care
deductible plan because the HMA account balance grows
so rapidly that the account can reliably cover any individual
or family deductible in a very short amount of time. Your
employees’ monthly, HMA account contributions will receive
a medical benefit crediting that continues to grow every
month and increases their HMA account value. With the
HMA Debit Card, your employees will earn the exact same
crediting rate that the HMRA offers, which results in your
employees receiving up to $3 or more in benefits inside of
their HMA account balance for every $1 that they contribute as
the program progresses to be used to pay for their out-of-pocket,
medical expenses
This accumulation of benefits for your employees easily
negates any of the tax benefits available in other medical
reimbursement account programs like an HSA. The biggest
differences between the HMA Debit Card and the HMRA program
is that it is the employee who owns their HMA medical savings
account, which the employee can either fund themselves with
post-tax dollars, or the employer can choose to fund tax free with
their HMRA reimbursements. Your employees’ HMA accounts will
also be portable with them if they leave the organization.
Just as with the HMRA program, National Prosperity is
also embedding other valuable services that are already
included for all of our HMA customers in their monthly
contribution including both unlimited telemedicine access with
no copays and our own proprietary, NPHM Rx Card Program that
provides some of the lowest, wholesale pharmacy drug prices
possible. By offering the HMA Debit Card to your employees,
you will be seen as very benevolent because this is an extremely
valuable, voluntary benefit and tool for your employees to help
them decrease their health care costs just like the employer has
the ability to do with the HMRA Program.
Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
13. Our Mission
At National Prosperity Health Matching Services, Inc., we believe one of
the key objectives for any successful business is to attain a balance of
both happy, healthy employees combined with strong, company financials.
We are committed to the development of innovative products to help
employers and employees to lower their annual health care expenses
significantly.
Our mission is to continually look for ways to offer our clients more
affordability without sacrificing quality. We believe taking good care of our
clients with the highest level of integrity and products that truly serve their
best interests will naturally lead to success.
About National Prosperity Health Matching Services
National Prosperity Health Matching Services, Inc. is based in Houston,
Texas and is the exclusive provider of Health Matching Reimbursement
Account products consisting of the HMRA®
program for employers and the
HMA™
Debit Card for individuals and families. Both the HMA and HMRA
programs are medical savings account programs that award increasing,
monthly, medical benefits to assist both employers and employees in
bringing down their first-dollar, out-of-pocket, medical costs. NPHM™
Services is a privately-managed, financial services company and first-
dollar, medical cost-containment company that is committed to bringing
down the cost of health care in the group and individual markets.
NPHM Services is expanding its reach and forming partnerships with
some of the largest brokers, benefit agencies and administrators all
across the country in the ERISA market to promote its revolutionary,
Health Matching Reimbursement Account programs, which includes the
HMRA program for employers and the HMA Debit Card for individuals
and families. The NPHM Services Board of Directors and founders bring
over a century of experience in the life and health services industry. It
is comprised of a CLU (Chartered Life Underwriter) and ChFC (Chartered
Financial Consultant) as well as the former Deputy General Counsel for
Health and Human Services in Pennsylvania. The founders are former
owners of one of the largest independent companies in the southwest
United States.
About Us
13Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
14. ??
How does NPHM™
Services award the HMRA benefits?
This fully HIPAA and ERISA compliant product was designed for
implementation by one of the most renowned life and health services
actuarial firms in the world today. Health Matching Reimbursement
Accounts utilize in-depth pooling and claims frequency analysis to
determine the rate of growth on contributions that can be awarded
monthly into the participating group member account balances. The
National Prosperity Health Matching Services claims exposure is
capped at each participant’s account balance, and NPHM Services also
maintains millions of dollars of it own reserves to back their programs.
What is the legal overview of the HMRA?
The Health Matching Reimbursement Account (HMRA) is offered
exclusively by National Prosperity Health Matching Services, Inc. The
HMRA is an ERISA (Employee Retirement Income Security Act), IRS
Section Code 105 plan that is also HIPAA compliant. The HMRA is
also a patent-protected product. The HMRA is an employer-sponsored,
medical reimbursement account program that is fully tax deductible at
the time of contribution. The HMRA awards a medical benefit crediting
on the monthly contribution designated to each participating group
member’s account balance in order to reimburse the employer on first-
dollar, 213(d) medical expenses, regardless of the existing member cost
sharing arrangement, up to the filing group member’s HMRA account
balance at the time of the claim.
What are the group size requirements for the HMRA?
The HMRA is ideal for any group (self-funded or fully-insured) with 20 or
more members that has less than a 50% annual employee turnover rate.
The HMRA reimbursements will serve to lower an employer’s fixed
and variable health plan costs and is also the ideal way to ease fully-
insured groups into self-funding. For those groups that don’t meet these
specifications, the employer may opt to offer the voluntary version of the
HMRA, which is a medical savings account known as the HMA™
(See
Page 12), to their group members instead. Your employees’ HMA accounts
will be portable with them if they leave the organization.
1
2
3
14
HMRA
®
Frequently Asked Questions
Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
15. ??
What if a group already has a HRA program
already in place?
The HMRA does not need to be utilized as a
replacement for either a traditional HRA or an
employer-sponsored HSA program. The HMRA
program builds tremendous savings for employers
through the growth of the HMRA first-dollar,
medical reserves and the subsequent employer
reimbursements that are received following
member health claims. These tax-free HMRA
reimbursements can instead be treated as a
complementary piece by serving as a funding
mechanism for an employer’s existing HRA, HSA or
wellness incentive programs or for the voluntary
benefits version of the HMRA for employees called
the HMADebitCard (See page 12). The HMRA can
also be used tax free to reimburse employees on
their Section 105 medical expenses.
Does the HMRA program work with
employer plans that are not high deductible?
Yes. The HMRA is compatible with low or high
deductible employer plans. In a self-funded
arrangement, the HMRA reserves and first-dollar
claim reimbursement incentives decrease an
employer’s first-dollar, claims exposure as well as
their variable costs and contingent liabilities by
providing the ability to increase their deductible
levels. This is because the HMRA account balances
will be covering such a large portion of the
employer’s claims cost risk as their HMRA medical
reserves build.
For fully-insured or partially self-funded employers,
the growth of HMRA reserves to cover future,
employee health care costs creates opportunities
to safely increase the employer or employees’
deductible levels in order to further lower everyone’s
fixed costs.
What happens to HMRA account
balances when members leave an
employer group?
The HMRA Employer Return of Benefits Rider
was designed for employers that have much
higher than average annual employee turnover
rates. As opposed to relinquishing the HMRA
account balances of all departing employees,
employers can opt to allocate a portion of those
account balance benefits from employees that
have terminated and have them spread equally
and added to their remaining employees’ HMRA
account balances.
The small cost of the HMRA Return of Benefits
Rider cost is usually only paid for in the first one-
to-three years of the program in order to neutralize
the cost of employees leaving the plan. The reason
for this is because of the increasing, annual,
tax-free reimbursements that will be flowing
back to the employer as the program progresses
that would not have been possible without the
HMRA in place. This will eliminate the need for the
HMRA Return of Benefits Rider over time. Even
by not opting for the HMRA Return of Benefits
Rider, the HMRA benefits that are awarded to the
employer in order to build their medical reserves
easily negate the effects of any departing group
members unless the annual, group member
turnover rate exceeds 50%.
Can Employers duplicate the HMRA
program themselves?
The HMRA program and the HMRA Helix
administrative software is proprietary and
patent-protected. National Prosperity Health
Matching Services, Inc. is the exclusive provider
of the HMRA program. The HMRA product was
developed over many years with the help from
one of the most renowned actuarial firms in the
world, who utilized in depth, claims frequency
and utilization analysis to design this program.
This program would not be safe to be attempted
by a third party due to its intricate structure and
associated risks.
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5
6
7
15Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
16. Health Matching Reimbursement Accounts Are Proprietary And Patent Protected
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well as any other associated or future patent owned, in whole or in part, by NPHM™
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bursement Account programs (HMA™
and HMRA®
) are not insurance products.
5120 Woodway Drive, Suite 10025, Houston, Texas 77056
Tel: (713) 850-8534 Fax: (713) 850-8579
www.nationalprosperity.com
Form No: HMRABRO-42016-V5
Revised Date: 4/27/16
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