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Health Reimbursements

Health Reimbursement Arrangements (HRAs) are employer-funded benefit plans that reimburse employees for eligible medical expenses.

Given a top level understanding of First Dollar's domain objects provided in the Health Wallet Introduction and Terminology, the following section will take you through the steps required to setup your HRA benefit, add it to organizations, and then enroll individuals.

Once the HRA is established using this guide, partners and organizations can control the benefit design and restrict eligible items using First Dollar's Health Wallet Manager web application.

Setup and Enrollment

Given a top level understanding of First Dollar's domain objects provided in the Health Wallet Introduction and Terminology, the following section will take you through the steps required to setup your HRA benefit, add it to organizations, and then enroll individuals.

Getting the HRA benefit template ID

One prerequisite to setup your HRA plan is to fetch the HRA benefit template ID. This can be done using the benefitsTemplate query. This will return an array of benefit templates, and you can find the HRA benefit template ID by finding the object with the type property of HRA.

query BenefitTemplates {
benefitTemplates {
... on BenefitTemplatesResults {
nodes {
id
name
description
type
configuration {
funding {
limits {
individual {
currency
lowestDenominationAmount
amount
display
}
}
initialFunding {
individual {
currency
lowestDenominationAmount
amount
display
}
}
}
}
}
pageInfo {
hasNextPage
endCursor
}
}
}
}

While we are specifically focused on the HRA in this guide, First Dollar is architected this way to allow for maximum flexibility in composing a benefit design across all benefit account types, and even allowing partners to create their own templates to create new types of lifestyle and wellness spending accounts.

Create Organizations

Next, use the createOrganization API to create an employer in our system. This allows you to create unique benefit programs per employer, and enroll employees in those programs as appropriate.

mutation CreateOrganization($input: CreateOrganizationInput!) {
createOrganization(input: $input) {
... on CreateOrganizationResult {
organization {
id
name
}
}
... on BadRequestError {
code
message
}
... on InternalServerError {
code
message
}
}
}

Create a Benefits Program

For each organization, you can then create a top level benefits program using the createBenefitsProgram API. A Benefits Program groups multiple Benefits together, enabling all of them to operate against a single Card, and defines shared settings that control Payment and Operational concerns for the grouped benefits.

mutation CreateBenefitsProgram($input: CreateBenefitsProgramInput!) {
createBenefitsProgram(input: $input) {
... on CreateBenefitsProgramResult {
benefitsProgram {
id
name
organizationId
benefits {
id
name
description
type
}
}
}
... on BadRequestError {
code
message
}
... on InternalServerError {
code
message
}
}
}

Create a Benefit

Then, use the createBenefit API to add the HRA to the benefit program for the organization. This call is where you will use the HRA benefit template ID.

mutation CreateBenefit($input: CreateBenefitInput!) {
createBenefit(input: $input) {
... on CreateBenefitResult {
benefit {
id
name
description
type
}
}
... on BadRequestError {
code
message
}
... on InternalServerError {
code
message
}
}
}

You can also set parameters such as the start date the HRA will begin. This way, you can set up and enroll individuals in the benefit weeks ahead of the start date, and individuals will not be able to access their accounts or receive card or makerting communications until the start date.

Create Individuals

Next, you'll create all individuals that need to be enrolled in these benefits. This can be done using the createIndividual API - call this API for each individual who should be enrolled in the benefit.

mutation CreateIndividual($input: CreateIndividualInput!) {
createIndividual(input: $input) {
... on CreateIndividualResult {
individual {
... on Individual {
id
}
}
}
}
}

Required Data for Individual Enrollment

First Dollar's philosophy on data collection is to collect the minimal amount of data required to administer accounts for our users while maintaining compliance. Clients of First Dollar's API should provide the maximum amount of data the client system has available for an individual.

The following data is required for all individuals being added to an HRA benefit:

  1. First and Last Name
  2. Physical Address (required for card carriers, mail, etc.)
  3. Date of Birth

The following data is optional for all users:

  1. Mailing address (physical address will be used if unspecified)
  2. Phone number
  3. Email address
  4. SSN

Note, if an email address is provided for a user, the email address must be globally unique (must not correspond to an existing user). If the provided email address is already in use, the request will be rejected as invalid.

Enroll the Individuals in a Benefits Program

Finally, use the enrollIndividualInBenefit API to enroll these individual into the benefits program that was also created earlier.

mutation EnrollIndividualInBenefit($input: EnrollIndividualInBenefitInput!) {
enrollIndividualInBenefit(input: $input) {
... on EnrollIndividualInBenefitResult {
individual {
id
}
benefit {
id
}
}
... on BadRequestError {
code
message
}
... on InternalServerError {
code
message
}
}
}

This API call will queue the process to send a card and marketing communications to the individual, but only on the specified start date of the benefits program.

Unenrolling Individuals From an HRA

When an individual's coverage changes or ends, the benefit may require a state change. In the general case, when coverage ends, the individual should lose access to the Benefit. This operation is implemented by the unenrollIndividualFromBenefit API.

Use the unenrollIndividualFromBenefit API to unenroll individuals from benefits programs when necessary.

mutation UnenrollIndividualFromBenefit(
$input: UnenrollIndividualFromBenefitInput!
) {
unenrollIndividualFromBenefit(input: $input) {
... on UnenrollIndividualFromBenefitResult {
individual {
id
}
benefit {
id
}
}
... on BadRequestError {
code
message
}
... on InternalServerError {
code
message
}
}
}

Note

The transferBenefitForIndividual API is not available to non-HSA benefits. Attempting to call this API for a non-HSA benefit will fail with error.

Making changes

All of the APIs cited above have complimentary APIs to update and make changes to benefits programs, organizations, and individuals. See our full API reference for additional endpoints that you can use to manage changes to an organization's benefits.