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QSEHRAs can provide reimbursement for medical expenses incurred by employees during the QSEHRA coverage period. Qualified Small Employer HRA (QSEHRA) QSEHRAs can provide reimbursement for medical expenses incurred by employees during the QSEHRA coverage period. This includes reimbursement for individual major medical health insurance premiums and other expenses under Code §213(d). Furthermore, a QSEHRA can cover premium payments for a spouse or other eligible family member, including post-tax paid through another employer's plan. Which employers are eligible for QSEHRAs? Available to businesses with fewer than 50 full-time employees that does not offer a traditional group health plan. An employer that provides a group health plan to current employees in an excludable category is not an eligible employer. Which categories of employees are not eligible? Excludable Categories: • Employees who have not completed 90 days of service • Employees who have not attained age 25 before the beginning of the plan year • Part-time employees • Seasonal employees • Non-participating employees covered by a collective bargaining agreement (if health benefits were the subject of good faith bargaining) • Non-resident aliens who do not receive earned income from the employer from sources within the United States. An employee must be offered the QSEHRA no later than the day after the date on which the employee ceases to fall within any of the excludable categories. "Discover the Tax Savings You Can Get with a QSEHRA" QSEHRA reimbursements are exempt from payroll and income tax. However, only employees who have minimum essential coverage (MEC) eligible for tax-free reimbursements. Employees without MEC must declare all QSEHRA reimbursements as taxable income when filing their taxes. Businesses cannot offer group health, dental, or vision insurance in addition to a QSEHRA. QSEHRAs are not HSA compatible. Employees that cease to be eligible would forfeit the remaining balance. COBRA does not apply. Employees cannot opt out of the QSEHRA. Employees with premium tax credits can participate in the QSEHRA, but their premium tax credit will be reduced by the amount of their QSEHRA allowance. Do QSEHRAs have notice requirements? To comply with regulations, employers are required to provide written notice to eligible employees at least 90 days prior to the of each plan year. If an employee becomes eligible for the QSEHRA after the plan year has begun, such as those hired midyear, the notice must be sent on or before the first day of eligibility. The notice can be sent in writing or electronically, following the IRS guidelines for electronic media usage.

An HRA is an arrangement that employers set up and completely funds to cover certain out of pocket, co-pays, co-insurance, and/or deductible expenses employees may incur associated with their health insurance plan. What is a Healthcare Reimbursement Arrangement? An HRA is an arrangement that employers set up and completely funds to cover certain out of pocket, co-pays, co-insurance, and/or deductible expenses employees may incur associated with their health insurance plan. It is an arrangement whereby employers promise to pay certain expenses on behalf of the employee to help reduce their cost of medical expenses, for themselves, their spouse, and dependent children. This arrangement is 100% paid for, funded, and designed by the employer for the employee’s benefit. Why would a company consider an HRA plan? Companies consider implementing HRA as a way to reduce the cost of health insurance premiums. By increasing the deductible of the health insurance plan, the premium to purchase the coverage can be reduced considerably. How does an HRA work? HRA’s are designed to work in conjunction with a high co-pay, high co-insurance, or high deductible health plan offered by the employer. Traditional health insurance plans have low co-pays, low co-insurance, and/or low deductibles, but because the health insurance rates and medical expenses continue to rise, employers are deciding to design and implement HRAs to reduce employees’ costs. By increasing the co-pay, co-insurance, and/or deductible, the cost of your health insurance premiums will decrease, but an employee’s out-of-pocket costs may increase. This is why employers implement an HRA to help employees reduce their potential out-of-pocket expenses while still providing them with a health insurance policy that offers complete coverage. HRA’s are effective in managing employees’ expenses, but they will be required to submit receipts or understand how to get reimbursed for an eligible expense covered by the HRA. How does the deductible get paid? There are several ways an employee can get reimbursed from the HRA depending on the options an employer allows. To the right are examples of how to get reimbursed. Many insurance companies will provide the claims data directly to HRC so employees will not have to submit to HRC for reimbursement. This will allow HRC to process and pay the claim directly back to the employee without them ever having to submit any paperwork to us for reimbursement. After the claim has been processed, the funds will be disbursed in accordance to the methods as outlined by your plan. An employee can submit a claim online, mail it, fax it, or drop the claim off to us along with the proper documentation necessary to prove they have incurred the expense. Proper documentation may consist of a letter that they will receive from the health insurance company. This letter is called a letter of explanation of benefits (EOB). In some cases, a receipt from the pharmacy may be all they need to submit. The proper documentation will be outlined by the employer. An employer may authorize the use of claims submission through the use of a Visa card. If an employer authorizes this form of reimbursement, an employee will receive a Visa card from HRC after they are enrolled. To use the Visa card, an employee simply presents it at an eligible location for an eligible expense. They may only use this card for eligible expenses and they must keep receipts, they may be contacted to verify the expense. Should an employer outsource the administration? There are many factors to consider when deciding to outsource the administration of paying the deductibles. Though pricing is important, it isn’t the only consideration to focus on. The employees will be submitting their claims for deductible reimbursement, and all of their personal information about what they had done will be on the EOB. Many employees will find this information private and may not want it shared with their employers. By outsourcing, the employer can get the claims paid, and the employee can rest assured that their information is kept confidential. It is also important to consider a Third Party Administrator who is set up for paying these types of claims. Employees are going to need an efficient streamlined process to receive their deductible money. Failure to reimburse an employee expediently could result in the employee receiving additional charges from their provider. Employers should consider using a TPA that can offer debit card processing for reimbursing the deductible. This would allow the employee to pay for their deductibles directly to the provider without having to submit claims for reimbursement.

Baby breathing monitor reimbursement is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Baby breathing monitor reimbursement is not eligible for a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Baby Breathing Monitor Baby breathing monitor reimbursement is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Baby breathing monitor reimbursement is not eligible for a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). Learn More Previous Next

A missed appointment fee is not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Missed Appointment Fee A missed appointment fee is not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). Learn More Previous Next

Swimming lessons are not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA), dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Swimming Lessons Swimming lessons are not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA), dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). Learn More Previous Next

Acne medicine reimbursement is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Acne medicine reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Acne Medicine Acne medicine reimbursement is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Acne medicine reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). Learn More Previous Next

The cost of a rehabilitation center for the treatment of an addiction or a medical condition is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Rehabilitation center reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Rehabilitation Center The cost of a rehabilitation center for the treatment of an addiction or a medical condition is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Rehabilitation center reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). Learn More Previous Next

Latex gloves are not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Latex Gloves Latex gloves are not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). Learn More Previous Next

Medicated face cream is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Medicated face cream is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Face Cream with Medication Medicated face cream is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Medicated face cream is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). Learn More Previous Next

Constipation medications are eligible over-the-counter (OTC) items with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Constipation medications are not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Constipation Medication Constipation medications are eligible over-the-counter (OTC) items with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Constipation medications are not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). Learn More Previous Next

Psychiatric care is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Psychiatric care is not eligible with a dependent care flexible spending account (DCFSA), or a limited-purpose flexible spending account (LPFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Psychiatric care Psychiatric care is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Psychiatric care is not eligible with a dependent care flexible spending account (DCFSA), or a limited-purpose flexible spending account (LPFSA). Learn More Previous Next

Speech therapy is eligible for reimbursement with flexible spending accounts (FSA), health savings accounts (HSA), and health reimbursement accounts (HRA). They are not eligible for reimbursement with dependent care flexible spending accounts and limited-purpose flexible spending accounts (LPFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Speech Therapy Speech therapy is eligible for reimbursement with flexible spending accounts (FSA), health savings accounts (HSA), and health reimbursement accounts (HRA). They are not eligible for reimbursement with dependent care flexible spending accounts and limited-purpose flexible spending accounts (LPFSA). Learn More Previous Next