coleboy Posted April 20, 2018 Share Posted April 20, 2018 Can a small business employer with less than 20 employees, who offers group health insurance, sponsor a section 105 Health Reimbursement Plan to reimburse employees who opt out of the group offering and enroll in Medicare Part B, D and supplement? Link to comment Share on other sites More sharing options...
Luke Bailey Posted April 20, 2018 Share Posted April 20, 2018 I'm confused. A QSEHRA can only be maintained by an employer that has no other health plan. So if this this employer "offers group health insurance," it can't have a QSEHRA. If what you are asking is whether an employer who has a health plan and thus does not qualify to have a QSEHRA can have a QSEHRA only for Medicare-eligible employees, I don't think so. Luke Bailey Senior Counsel Clark Hill PLC 214-651-4572 (O) | LBailey@clarkhill.com 2600 Dallas Parkway Suite 600 Frisco, TX 75034 Link to comment Share on other sites More sharing options...
Chaz Posted April 23, 2018 Share Posted April 23, 2018 If a fewer-than-20-employer employer otherwise meets the requirements to offer a QSEHRA (e.g., does not offer medical coverage at all), I believe without researching that under the QSEHRA rules the employer could reimburse Medicare Part B, D, or supplement premiums through it. It couldn't do it for just the Medicare folks as that would violate the rule that it generally apply to all employees. Link to comment Share on other sites More sharing options...
Gary Kushner Posted April 26, 2018 Share Posted April 26, 2018 Luke and Chaz are correct that if the employer offers any group health coverage, it cannot establish a QSEHRA (IRS Notice 2017-67/Q&A-4). And you're correct that you can only offer that kind of incentive by an employer with fewer than 20 employees since otherwise the Medicare Secondary Payor rules would kick in, prohibiting any incentive to drop group health coverage in favor of Medicare. If these are active employees, and you can pass the 105(h) nondiscrimination tests on eligibility and benefits, there is a narrow tightrope that you might be able to navigate to enable a "regular" HRA that is limited to reimbursing only Parts B and D Medicare premiums in an under-20 employee organization. Link to comment Share on other sites More sharing options...
Luke Bailey Posted May 31, 2018 Share Posted May 31, 2018 Question. If the employer has more than 20 employees, say it has 40, but it's only plan is a QSEHRA, then do we really think that the MSP rules will prohibit the employer from reimbursing Medicare Parts B, C, and D premiums? Even if (and I have not run through the analysis), the QSEHRA would satisfy the Medicare definition of a group health plan (GHP), the employer would not be reimbursing the premiums as an inducement for the Medicare-eligible employee to drop the employer's GHP, since the QSEHRA is the employer's "GHP." Luke Bailey Senior Counsel Clark Hill PLC 214-651-4572 (O) | LBailey@clarkhill.com 2600 Dallas Parkway Suite 600 Frisco, TX 75034 Link to comment Share on other sites More sharing options...
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