Enrollment Resources for Health Reimbursement Arrangements (HRA)
This page shows enrollment resources for your HSA. If you wish to view all resources for your Plan, please click below.
Enrollment is Easy with EMPOWER's Four-step Process!
Send Pre-enrollment educational materials to employees
2
Use EMPOWER’s enrollment forms or use your own.
Send Enrollment to EMPOWER through our enrollment spreadsheet or EMPOWERConnect.
Send Welcome materials to employees to help them use their new benefits.
Pre-enrollment Employee Education
Although employees are typically automatically enrolled in an HRA when they enroll in the associated Group Health Plan, EMPOWER has provided materials below to educate employees.
Flyers
English
Spanish
Traditional HRA Flyer (PDF)
PDF guide that explains HRAs to employees.
HRA Plan Fact Sheet (PDF)
A single page handout that contains specific details about your Plan.
Your Account Manager will email this to you before open enrollment starts.
QSEHRA Notice
Employers are required to send a notice to employees 90 days prior to the start of the QSEHRA Plan Year.
Ask your Account Manager for this notice.
Videos
Enrollment Forms
QSEHRA Enrollment Form
Employees should use this form to provide initial attestation of minimum essential coverage.
Enrollment Spreadsheet
EMPOWER accepts enrollment through EMPOWERConnect or the below enrollment spreadsheet. Please click the link below for instructions on how to submit the enrollment spreadsheet. Note that this enrollment spreadsheet will work for all EMPOWER benefits.
Enrollment Spreadsheet
This link contains instructions on how to submit enrollments to EMPOWER. The instructions include a link to download the spreadsheet template.
Post-enrollment Employee Education
EMPOWER accepts enrollment via our enrollment spreadsheet or EMPOWERConnect. We have provided the following enrollment forms if you would like to distribute and collect from your Employees.
Flyers
English
Spanish
HRA Plan Fact Sheet (PDF)
A single page handout that contains specific details about your Plan.
Your Account Manager will email this to you before open enrollment starts.
QSEHRA Welcome Guide
PDF Guide that explains the QSEHRA for participants.
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