The HRA will be administered by Diversified.
Pay directly at the service provider using the Benefits Debit Card or reimburse yourself for any IRS Code Section 213(d) Eligible Medical Expense incurred for the 2025 calendar year.
Benefit Amount
Member Only : $1,000.00
Member + Spouse: $2,000.00
Member + Child(ren): $2,000.00
Member + Family: $3,000.00
Members who have not yet signed up to receive a debit card must fill out an Enrollment Form to request a debit card.
Click here or on the Benefits Card image to the right for the form. Return the completed form to Diversified using the instructions on the form.
Members and their dependents covered by the Plan are eligible for up to a $5,000 maximum lifetime benefit for any FDA approved procedures to improve your eyesight.
Beginning January 1st, 2025, the Advanced Eye Care Reimbursement benefit will be administered by Diversified. For more information or to request reimbursement visit www.div125.com.
The Advanced Eye Care Reimbursement benefit does not cover cataract surgery
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