Open enrollment has a familiar rhythm: a benefits guide lands in an inbox, a webinar gets scheduled, and somewhere between the deductible table and the 47th slide, employees are expected to make a decision that affects their family's health and finances.
Then someone adds a spousal HRA to the mix.
For employees, it can be a lot to take in. A spousal HRA is still new to many people, and most benefits guides give it roughly one paragraph to explain how it works.
That's where Healia comes in.
Meet "Ask an AM"
At Healia, employees and their spouses can schedule one-on-one time with a real person on our account management team. We call it Ask an AM.
These aren't scripted calls or recordings. They're actual conversations about the questions employees have about their benefits.
And sometimes those questions get personal.
A specific prescription. A paycheck. A spouse's health plan. A very specific "what if" involving a deductible and a doctor's visit next Tuesday.
Employees should be able to ask those questions without wondering who's listening or accessing their PHI.
Healia can't share the specifics of those conversations. But after answering a lot of spousal HRA questions, we can share the broad strokes.
Here are the questions we hear most often.
"Okay, but what's the catch?"
Honestly, this is usually question number one.
And it's understandable.
A spousal HRA is unfamiliar to a lot of employees. If an employee has never heard of one before, it can be hard to believe that their employer is offering to reimburse their family's eligible healthcare expenses simply because the household enrolls in a spouse's plan.
So employees, and especially spouses who are hearing about the benefit for the first time, want to know:
What's the catch?
Our account managers walk employees through how the spousal HRA works, what it covers, how reimbursements work, and why an employer would offer the benefit in the first place.
Once the mechanics click, the reaction is often some variation of:
"Oh. That's genius!"
Understanding a benefit is a lot easier when an employee can ask a human being instead of trying to decode a benefits PDF at 9:47 p.m the day before Open Enrollment closes.
"Can you help me figure out whether my plan or my partner's plan is actually better?"
This is where the Decision Support Tool (DST) comes in.
Comparing two health plans sounds straightforward until employees start looking at premiums, deductibles, out-of-pocket maximums, prescriptions, family coverage and expected healthcare usage.
Then it becomes... less straightforward.
During open enrollment, employees often walk through the DST with an account manager and plug in the numbers that actually matter to their household.
Questions sound like:
- What happens to an employee's costs if they take a particular prescription?
- How would the deductible work over the course of the year?
- Is the spousal HRA actually a better deal for the employee's family?
- What happens if the employee has a baby?
- What if one member of the household has a really expensive year?
Those are difficult questions to answer with a generic benefits guide because healthcare decisions aren't generic.
The DST helps employees compare their options using their own circumstances. And when an employee wants a second set of eyes, an account manager can walk through it with them.
Sometimes the best benefit experience is simply having someone say, "Yep, let's look at that together."
"Can I still have an HSA?"
This one comes up a lot.
HSAs already come with their own collection of questions. Add a spousal HRA and employees understandably want to know how the two interact.
The good news is that a spousal HRA can be designed to preserve HSA eligibility.
With a Post-Deductible HRA, employees can remain HSA-eligible and continue making HSA contributions, including contributions from their spouse's employer. Healia reimbursements begin once the employee meets the federal minimum deductible required for HSA eligibility.
We hear questions like:
- Can an employee contribute to an HSA while participating in a spousal HRA?
- What happens to the money already in an employee's HSA?
- Does the spousal HRA affect HSA eligibility?
These questions can get technical quickly, and the answer can depend on the specific coverage and circumstances involved.
That's why this is another area where talking to someone who understands spousal HRA and HSA rules is much more useful than hoping the answer is buried somewhere on the IRS website.
"Okay... so how do I actually use this thing?"
Once enrollment ends, the questions get a lot more practical. Employees want to know what to do when it's time to actually use the benefit.
After enrollment, Ask an AM conversations tend to get much more specific. Employees want to know how to submit a claim, why a claim was denied, what exactly an EOB is, or whether a screenshot from their spouse's insurance portal is enough documentation.
These aren't unusual questions. Most employees don't spend enough time thinking about benefits paperwork to become experts in it, and they shouldn't have to.
Our goal is to make the process as straightforward as possible. Sometimes an employee has everything they need and submits a claim in a few minutes. Other times, they want someone to walk through the process with them or confirm that they've uploaded the right document.
That's where human support comes in. An account manager can jump on a screen share, help track down the right documentation, reset a password, or answer a question before it turns into a frustrating afternoon.
A benefit can be simple to use and still deserve a human touch, especially when employees are making decisions that can have a meaningful impact on their health and finances.
"What happens if I have a question six months from now?"
Employees can still reach out.
Spousal HRA support shouldn't disappear the second open enrollment ends. Questions come up throughout the year, especially when an employee gets married, has a baby, changes jobs or has another qualifying life event.
New hires don't necessarily want to sit through an hour-long webinar about a benefit they need to understand today. They may just want someone to explain their options and answer a few questions without making them feel like they should have already known the answer.
That's why Ask an AM is available year-round. Employees can get help when they actually need it, whether that's during open enrollment or six months later when a question finally comes up.
Why employee support matters to HR and brokers
For HR teams and brokers, good employee support has a pretty straightforward payoff: fewer questions land in the HR inbox.
When employees can get answers directly from someone who understands the spousal HRA, HR teams don't have to become the resident expert on every reimbursement rule, claim question and HSA scenario.
There's a second benefit that's just as important. When employees understand how their spousal HRA works, they're more likely to feel comfortable using it. And when they know there's a real person available to help when something goes sideways, they don't have to figure everything out on their own.
That's why we don't think employee support is a nice extra attached to a spousal HRA. It's part of what makes the benefit work. The benefit itself may be straightforward, but employees are still making decisions that can have a meaningful impact on their families, and having someone there to help matters.
Generic Advice Doesn't Work for Personal Decisions
One of our favorite things about Ask an AM is that the questions aren't the same for every employee.
That's because healthcare is personal. A benefits decision that makes perfect sense for one household might be completely wrong for another. Employees shouldn't have to choose between figuring it out themselves and calling a generic call center.
They should have somewhere to go when the standard explanation doesn't quite answer their question. Maybe it's a question about a prescription, a spouse's plan, an HSA or a claim that doesn't make sense. Those are the questions that rarely fit neatly into a benefits guide, but they're often the questions employees care about most.
If you're an HR leader or broker considering a spousal HRA, we'd be happy to show you what employee support can look like before, during and well after open enrollment.
Want to see what Ask an AM could look like for your spousal HRA rollout?