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Health Reimbursement Arrangement (HRA)

State of New Hampshire employees and their dependents (18 years of age or older) enrolled in a State of New Hampshire medical plan are eligible to complete the Health Assessment Tool (HAT) available through the Mobile Health app or website.

Plan Information for Health Reimbursement Arrangement benefits
Overview Earn $200 pre-tax dollars for a Health Reimbursement Arrangement (HRA) to pay for eligible medical co-pays, co-insurance and deductibles (if applicable), prescription drug copays, and eyewear (glasses or contact lenses).

The Health Reimbursement Accounts are managed by ASIFlex.  You can use this account to pay these expenses for yourself and your dependents, even if your dependents are not covered by a State of New Hampshire health care plan. The State of New Hampshire limit for the amount of pre-tax money that it will contribute for your completion of the HAT is $200.
Who is Eligible? All State of New Hampshire employees and their dependents (18 years of age or older) enrolled in a State of New Hampshire health plan. However, only the state employee* that is the subscriber of the health plan is entitled to the $200 HRA benefit for taking the HAT.

*Please note: If two State employees are married and both are covered on the same medical policy, only the subscriber of the plan is entitled to the $200 HRA benefit for taking the HAT. If they are each covered on separate medical policies and are both subscribers, then they would both be entitled to the $200 HRA benefit for taking the HAT.
How to Earn the HRA In order to receive the $200 HRA, eligible employees must complete the HAT on or after January 1st, of each calendar year. Completing the HAT is voluntary. Whether or not you choose to complete the HAT has no effect on your employment at the State of New Hampshire, your health benefit coverage or your eligibility to receive medical care.

Please visit Health Education and Wellness Health Assessment Tool for more information.
How to Earn Health Rewards Upon completion of the HAT, the State employee, as well as their spouse/child who is also a State employee, may be eligible to complete 3 wellness activities and earn up to $300 in gift cards*.

Please visit Health Education and Wellness Health Rewards Program for more information.

*The gift cards are a taxable benefit. The value of the benefit you redeem up to $300 shall be added to your gross salary through payroll.
How it Works
  1. Members must be registered with Mobile Health in order to take the HAT.
  2. Upon completion of the HAT, ASIFlex will be notified of your completion and the date your $200 HRA should go into effect. ASIFlex will establish your HRA account. If you already have a medical flexible spending account with ASIFlex and have received a debit card, you will use this same card to access your HRA account to pay for out of pocket medical expenses such as deductibles, co-pays, co-insurance (if applicable) and eyewear (glasses or contacts). The HRA account funds will be used prior to your FSA dollars during the plan year for qualified medical expenses under the HRA until those funds have been exhausted.
  3. If you earned a $200 HRA for completing the HAT, you have until March 31 of the following plan year to submit receipts for reimbursement of eligible HAT expenses, provided the expenses were incurred between the date you took your HAT for that plan year and December 31 of that plan year. Any remaining unused dollars unclaimed as of March 31 of the next plan year will be forfeited. You can logon to the ASIFlex website to view your account balance at any time.
  4. Upon completion of the HAT you, as well as your spouse/child who is also a State employee, may be eligible to complete Health Rewards Program Activities to earn up to 300 points which can be redeemed for gift cards*. Points must be redeemed on or before December 31 of that plan year. Points not redeemed before year end will be forfeited.
*The gift cards are a taxable benefit. The value of the benefit you redeem up to $300 shall be added to your gross salary through payroll.
When Can I Access My HRA The effective date of your HAT completion is the effective date of the availability of your $200 HRA. However, it takes approximately 2 to 3 weeks from when you complete your HAT to when you can see the $200 HRA account on the ASIFlex website. If you incur costs prior to your account being established, keep your receipts for your qualified medical expenses you have spent out of pocket and once your account is established you can submit your claim(s) for reimbursement provided the date of services is on or after the date you completed your HAT.
How to Submit Claims? You have four options for submitting your Health Care HRA claims:
  1. Pay for eligible health care expenses directly using your ASIFlex FSA debit card. Click here for an ASIFlex Debit Card FAQ.
  2. Submit your claim online through ASIFlex, State of New Hampshire's FSA administrator.
  3. Submit claims using ASIFlex's free mobile app.
  4. Complete a Health Reimbursement Account (HRA) Claim Form and submit a receipt for each expense incurred. Fax or mail your completed claim form to:

    FAX: 1-877-879-9038

    Mail To:

    ASIFlex
    PO Box 6044
    Colombia, MO 65205-6044

Benefit Booklet Health Reimbursement Arrangement (HRA) Benefit Booklet

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