This Week’s Focus

Week 1: Keep the Plan. Fix the Flaw.

The simplest, most overlooked opportunity: Using a Limited-Line HRA to plug one specific gap in a health plan.

Common Gaps This Can Fix

  • Tier 3 or specialty prescriptions that are unaffordable
  • Need for just a few more mental health sessions
  • Coverage for GLP-1s, infertility, or travel for care
  • One copay or coinsurance amount causing pain

Why This Works

  • No need to replace the whole health plan
  • No need for a broader MERP/HRA or multi-benefit program
  • Just a targeted, affordable fix

What Is a Limited-Line HRA?

Covers a specific gap in a health plan without the cost or complexity of a full MERP

Tax-free, compliant, and easy to administer

Reimburses employees for one or two defined categories of care

Works alongside any group medical plan (including ACA-compliant and fully insured)

Keeps the benefit experience strong without disrupting the rest of the plan design

Cost & Administration

Monthly Cost:

$5 per employee, per month for narrowly defined benefit categories

Pricing applies to single-benefit or limited-scope designs; broader programs are custom quoted

Included Services:

  • Claims processing
  • Dedicated customer service
  • Spanish-language support

Examples: Gap → HRA Fix

Mental health visit caps

Reimburses sessions after carrier’s limit is reached

Tier 3 or specialty prescriptions

Covers high-cost meds not fully paid by plan

GLP-1s & weight management Rx

Targets excluded or capped drug categories

Infertility / family-building benefits

Offers flat-dollar support for uncovered services

Out-of-network / second opinions

Covers consults when a specialist is out of network

Travel for care

Reimburses mileage, lodging, or meals for out-of-area treatment

One-off high copay (e.g., specialist)

Helps cover a specific service with consistent cost share

How to Pitch It

Listen for client comments like:

  • “We love our plan, but…”
  • “We just wish it covered…”
  • “Our employees keep asking about one specific thing…”

Present the limited-line HRA as:

  • Affordable
  • Fast to implement
  • Flexible

Bottom Line

Sometimes the best move isn’t a big change — it’s a small, smart one.

Let’s fix the flaw.

Download free flyer for Week 1 here:

File upload

EBA&M CLOSE THE GAPS FLYER.pdf

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📧 Contact: sales@ebam.com
📅 Book a 15-min strategy call:


EBA&M

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