Medical Expense Reimbursement Plan (MERP)

You are eligible for the MERP if you are a new employee, were enrolled in the Prime Healthcare EPO Plan the day before the new MERP plan year started. You also qualify if you were already enrolled in MERP last year.

You can enroll in the MERP during your Open Enrollment Period or during a qualifying life event. Contact your Human Resources department for assistance.

If you have access to alternate group medical and prescription drug coverage, your MERP offers nearly 100% coverage. The program will reimburse you for eligible co-pays, co-insurance and deductibles incurred through your alternate group medical plan up to $9,450/single and $18,900/family per year.
No premium contribution will be deducted from your paycheck. In addition, you can receive an Opt-Out credit from your employer after filling out the Opt-Out form.

You can use your benefits for your co-pays, co-insurance, and deductibles that you and your family might have to pay under a different group health plan.

You can access your benefits by swiping your debit card at the time of service or while picking up a prescription. If you don’t have your debit card handy, submit a claim by uploading the receipts in the mobile app or by filing a paper claim.

You might currently be enrolled in a Health Reimbursement Arrangement (HRA) or a Flexible Spending Account (FSA). It’s important to note that reimbursement cannot be obtained simultaneously from both the MERP and your HRA or FSA.

You have various options available for filing a claim: through our portal, the Mobile App or the conventional paper method.

Visit prime.pinnacletpa.com and request reimbursement. For a QuickStart guide, please refer to the resources tab.

Request reimbursement by visiting prime.pinnacletpa.com. Refer to the resources tab for a QuickStart guide on how to file a claim.

If you choose to go the paper route, follow these steps:

1. Complete the MERP claim form.
2. Sign the claim form.
3. Send the claim for to MERP@pinnacletpa.com, fax it to (949) 253-5420 or mail it to the following address:

Pinnacle Claims Management Inc. 

P.O. Box 2220 

Newport Beach, CA 92658

Traditionally, claims are paid between 1-2 weeks, but it can take up to 30 days. If you need assistance with a claim, please contact customer service at (866) 642-2932 or email customerservice@pinnacletpa.com.

We have created a QuickStart guide that will walk you through how to use the debit card and the reimbursement portal.

You will receive your debit card in 7 to 10 days via the USPS once you complete your attestation and set up your benefits.

You will be receiving two cards: one for your personal use as the employee, and another for your dependents. Please keep in mind that your name, as the employee, will be printed on both cards.

Yes. The payment will not be accepted at locations that do not offer eligible goods and services, such as hardware stores, restaurants, bookstores, gas stations and home improvement stores. For example, you can use your debit card at Target in the pharmacy, but you cannot use the debit card at the main checkout registers.

You can call customer service at (866) 642-2932 or email customerservice@pinnacletpa.com.

Your debit card will be ready to use on 1/1/2024.

Go to the Login Page and enter your Username and password
(both provided by Pinnacle Claims Management Inc.).

Username: Email Address
Temporary Password: First Name initial + Last Name + DOB (ddmmyyyy). Initial and last name needs to be in all CAPITAL LETTERS.
Example: John Doe October 24, 1972, would be JDOE24101972

Click Login

Yes, you can download the Mobile App by searching “PCMI HSA/FSA Savings Account” in the app store. It is available for both Android and Apple phones.

You can also access the app by clicking here for Apple phones and here for Android phones.

For a Mobile App Guide, please refer to the Resources tab.