Please be advised that the UltraBenefits contract ended on June 30, 2022. UltraBenefits was the plan administrator for the City’s Health Reimbursement Arrangement (HRA). All claims incurred from July 1, 2021 through June 30, 2022 will continue to be processed and should be submitted directly to UltraBenefits. Employees will have until October 31, 2022 to submit claims incurred during this time frame for reimbursement.
Out of Pocket Expenses
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 for:
- Level 1: High Cost Co-payments.
- Level 2: Out-of-Pocket Expenses.
Summary and overview of the Health Reimbursement Arrangement (HRA) benefits.
To learn more, please see a presentation by UltraBenefits by clicking here
HRA Manual Claim Form
Use this form to submit claims manually via email, fax or mail.
HRA Attestation Form
Use this form to assist with tracking out-of-pocket expenses.
Employees are encouraged to contact UltraBenefits directly at 866-858-7223, ext 68107 for claim related assistance.
Employees may also contact Human Relations at 978-674-4105 for general assistance.
UltraBenefits now has an online portal available to eligible employees wishing to access and view HRA related information. Those interested will need to create an account prior to log in. Guide to creating an account