New City Guidance for HCSO

City Guidance Now Suggests:

  1. Employers keep the general purpose HRA design for the 24 month spend down for all 213D medical expenses.
  2. Require waivers for individuals that qualify for the tax credit from Covered California.

They would evaluate plans that do not allow 213D medical expenses to verify that they are reasonably calculated.  i.e. apply the average 20 hour maximum guidelines to the spend down.

How BeneFLEX will Administer My HCSO HRA Accounts

  • 2012 & 2013 quarterly rewards can be used for any eligible medical expense, as listed below.
  • City guidelines state new 2014 & future rewards can only be used for an excepted benefit, as listed below.  (only for employees who work an average of 8 to 20 hrs a week)
  • Beginning with the 1st Quarterly Statement for 2014, rewards will be labeled by the year/quarter they were earned and as Dental/Vision/LTC (excepted benefit), if applicable.   

If employees have money remaining in their 2012 or 2013 medical HRA reward accounts and qualify for a tax credit on the Covered California Exchange, they must sign a waiver converting their medical HRA to an excepted benefit HRA for Dental/Vision/LTC only.

 Eligible Medical Expenses:

 Doctor ● Dentist ● Eye Exams ● Contact Lenses ● Chiropractor ● Eyeglasses ● Band –aids ● RX ● Acupuncture ● Psychologist Fees ● Orthodontia

For a complete listing of HCSO HRA eligible expenses, visit our website at

Excepted Benefits for 2014 Rewards:

● Dental benefits limited to treatment of the mouth;

● Vision benefits limited to treatment of the eye;

● Medical indemnity insurance;

● Long-term, nursing home, home health, or community-based care; and

● Coverage limited to a specific disease or illness.