Starting in 2026, eligible employees and dependents currently enrolled in our Medical plan and new hires can opt out of Intact medical coverage and enroll in a spouse’s employer-sponsored plan. In return, Intact will reimburse up to $21,200 in out-of-pocket medical costs through the Spousal Incentive HRA (SIHRA).
The SIHRA is free for you and your eligible family members to join. There is no payroll contribution required to participate in the SIHRA. You will just need to pay the premiums for your spouse’s employer sponsored medical coverage.
How do I enroll in the SIHRA?
- Enroll in your spouse’s health insurance through their employer.
- During open enrollment at Intact choose the “SIHRA.”
- You’ll then have up to $21,200 of your out-of-pocket costs covered!
How do I use the SIHRA once I enroll?
It’s simple!
- Present your insurance card from your spouse’s health plan to the provider or pharmacy.
- Once you receive the EOB, doctor’s bill, or pharmacy receipt, upload it to Healia’s online portal.
- Our partners at Healia will review the claim and reimburse you for the expense!
Are there any restrictions?
You must opt-out of health insurance with Intact and enroll in your spouse’s employer sponsored medical coverage. Employees that have already waived health coverage with Intact are not eligible for the SIHRA.
Can I enroll in my spouse’s Medicare or ACA plan?
No, you must enroll in a group health plan sponsored by your spouse’s employer. Medicare, Medicaid, Tricare coverage, or a plan on the ACA marketplace are not eligible. Your spouse may also not be enrolled in a Intact plan themselves.
What happens if my spouse’s plan does not include my current doctor or a procedure?
The SIHRA can only reimburse you for procedures, services, and prescriptions that your spouse’s plan covers. Please check network access on your spouse’s plan and the prescription formulary to ensure coverage.
What if I lose access to coverage on my spouse’s plan?
Loss of coverage is known as a “Qualifying Life Event.” As long as you let Intact know within the correct notification window, you and your eligible dependents may enroll in an Intact plan without a lapse in coverage.
Can I enroll in the SIHRA and a High Deductible Health Plan (HDHP)?
Yes, you are eligible to enroll in an HDHP as long as you and your family do not contribute to a Health Savings Account (HSA) or receive employer contributions to an HSA. The HSA and he SIHRA are both pre-tax programs, so the IRS does not allow you to be enrolled in both at the same time.
Note: if you have an existing HSA balance from a previous plan year, you can still keep and use it if needed!
Have a question? Email our partners at Healia at support@healiahealth.com.