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Health Reimbursement Arrangement (HRA) Benefits

The City of Lowell provides a supplemental Health Reimbursement Arrangement (HRA) plan designed to reimburse for certain out of pocket expenses.

Effective July 1, 2016, the Health Reimbursement Arrangement (HRA) will be administered by UltraBenefits. Although the plan administrator has changed, the HRA plan will continue to reimburse eligible out-of-pocket expenses as it previously has: Level 1: High Cost Co-payment and Level 2: Out-of-Pocket Expenses.
​Document Description​
HRA Explained​ Summary and overview of the Health Reimbursement Arrangement (HRA) benefits.
HRA Attestation Form ​Use this form to assist with tracking out-of-pocket expenses.
HRA Manual Claim Form ​Use this form to submit claims manually via fax or mail.

Employees are encouraged to contact Samantha Letourneau at UltraBenefits directly at 866-858-7223 ext. 68109 for claim related assistance. Employees may also contact Human Relations at 978-674-4105 for general assistance.