Health Reimbursement Account (HRA)

Required Documentation



Employees electing to enroll in an HRA will be required to submit documentation, in pdf format, that indicates that they are eligible to participate in an HRA. The documentation will need to be scanned and uploaded into the Membership Administration Portal (MAP) at the time the member is enrolling.

Examples of required documentation are:

  • Medicare Card – for those enrolled in any part of Medicare
  • TriCare Card- for those enrolled in TriCare
  • If the member will be gaining Social Security benefits after the age of 65 during the plan year, they will need to submit:
    • Written intent from the member stating that they will be applying for Social Security benefits within the plan year.
  • For proof of being eligible to be claimed as a dependent under a parent’s tax return, submit:
    • Copies of parent’s current year’s filed Federal tax return showing your name as an eligible dependent Please note all income information may be whited out prior to submission to SEHP Membership Services. The pages needed from the current year’s filed Federal tax return depends on which Tax form was filed:
      • Form 1040—pages 1 & 2 containing the filer’s name, the parents’ signature, and a written signature date parents signed the form.
      • Form 1040A—pages 1 & 2 containing the filer’s name, the parents’ signature, and a written signature date parents signed the form
      • Form 8879 (IRS e-file)—containing the date filed, the filer’s name, the parents’ signature, and a written signature date parents signed the form