Purdue Global Health Fund Plan FAQ

For the 2023 plan year UMR will be the administrator for the HRA funds associated with the Health Fund Medical Plan.

For members who were enrolled in the Aetna Health Fund Plan in 2022, this FAQ will give guidance to how the accounts will transition from Aetna to UMR and what to expect in the 2023 plan year.

Members with 2022 HRA funds with Aetna

• Aetna will continue to manage the 2022 HRA funds for a 90-day runout period (01/01/23-03/31/23) to process any 2022 claims that are received after January 1, 2023.
• After the 90-day period, all accounts with remaining funds will transfer to UMR to manage going forward.
• During the 90-day runout period, UMR will manage the 2023 HRA funds and apply funds to 2023 claims. Any claims with a member responsibility that is more than the amount of the 2023 funds, can be submitted for reimbursement from the remaining 2022 funds, if any are available.

What to expect in 2023

For the 2023 plan year, members who enrolled in the Health Fund Plan, will receive a new member ID card and a UMR Rx only debit card, that can be used at the pharmacy to purchase prescription medications. Because UMR will not process pharmacy claims, members will need to use the debit card to use HRA funds at the pharmacy. This will be a change to the way prescription claims processed in 2022.

Q. How will UMR process claims?
A. UMR will process medical claims the same as Aetna. When a claim is processed, any funds in your HRA will automatically apply to the member portion of the claim.

Q. What if my 2023 claim is more than the funds in my 2023 funds will cover?
A. Any claims with a member responsibility that is more than the amount of the 2023 funds available, can be submitted for reimbursement from the remaining 2022 funds, if any are available

Example – If a single individual has a claim in January 2023 for $1000, the full amount of $250 from the 2023 HRA funds will apply to the out-of-pocket amount and the member will still owe $750 to the provider. After the runout period in April 2023, the member can submit a manual claim for reimbursement of the remaining $750 assuming the remaining 2022 funds in any, are available.

 

Will the full amount of the 2023 funds be available in January or are they prorated?
Anyone effective January 1, 2023, will have the full annual amount available immediately. Monthly proration only occurs for mid-year hires or when moving from single to family coverage mid-year.

How much will Purdue Global contribute to the Health Fund accounts?

2023 Health Fund Employer	$250	Employee only
	$500	Employee + One (Child or Spouse)
	$750	Family

Q.How do I check the balance in my HRA account?
A. You can check your balance online through the UMR Member Portal at www.umr.com.

Q. How will pharmacy claims process?
A. The pharmacy claims will process through CVS-Employers Health then the claims data is shared with UMR to apply toward your out-of-pocket maximum.

Q. How do I use my HRA funds for prescription medications?
A. UMR will issue a Rx only debit card that can be used at the retail pharmacy to purchase prescription medications. The Rx debit card can only be used to purchase prescription medications. The card cannot be used for any other expenses.

Q. How do I use my HRA funds to pay for mail order and specialty pharmacy?
A. If your medication is shipped to you, you will be able to use the HRA debit card to pay for medications before they are shipped.

Q. Will I be eligible to have a Health Care Flexible Spending Account (HCFSA) with the Health Fund Plan?
A. Yes. If you would like to contribute additional pre-tax dollars to use for your tax qualified medical, prescriptions, vision, and dental expenses, you may enroll in a HCFSA at open enrollment.

Note - Payflex will continue to be the administrator for the pre-tax savings accounts.

Q. Who should I contact for concerns regarding the Health Fund Plan or the HRA fund account?
A. You can contact UMR Plan Advisor to assist with you benefit questions. Plan Advisor is the customer service 800-207-3172