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News Items, by Subject

Health reimbursement accounts (HRAs)


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[Guidance Overview] Is the Proposed Expansion of Health Reimbursement Arrangements a Game Changer for Employers?
"The proposed regulations may be especially useful for small and medium-sized companies that want to be able to define the costs that they are willing to pay towards employee health insurance coverage by using HRAs with a fixed annual employer contribution and that have a small enough workforce to satisfy some of the consistency requirements of the proposed regulations." (Epstein Becker Green)
[Opinion] American Benefits Council Comment Letter to IRS on Proposed Regs for HRAs and Other Account-Based Group Health Plans
16 pages. "We support the Proposed Rule's goal of expanding the availability of HRAs and permitting their use in combination with policies purchased on the individual insurance market and welcome the increased flexibility it provides for both employees and employers.... In order for the Proposed Rule to achieve its goals, it is vital that the individual market be stable and well-functioning, otherwise, employers will be unwilling to utilize this expanded flexibility." (American Benefits Council)
[Opinion] ECFC Comment Letter to HHS, IRS and DOL on Health Reimbursement Arrangements and Other Account-Based Group Health Plans (PDF)
"We request clarification that substantiation need not occur upon initial ICHRA enrollment; rather substantiation prior to first reimbursement would be adequate.... We would ask that an additional class of employees be considered: exempt and non-exempt employees.... We request confirmation in the final regulations that classes are determined on an employer-by-employer basis not on a controlled group basis." (Employers Council on Flexible Compensation [ECFC])
Five Ways Small Organizations Can Provide Better Health Benefits To Employees
"[1] Offer tax-preferred accounts (FSAs and HSAs).... [2] Offer voluntary products.... [3] Add limited purpose FSAs.... [4] Put a wellness program in place.... [5] Look into QSEHRAs." (Forbes)
[Opinion] Effects of Weakening Safeguards in the Administration's Health Reimbursement Arrangement Proposal
"The proposed rule ... bars employers from offering this type of HRA side-by-side with a traditional health plan; it requires employers to offer this type of HRA on the same terms to all similarly situated employees; and it bars employers from using this type of HRA to subsidize short-term, limited duration coverage.... [A]bsent these safeguards, the Administration's HRA proposal would cause very large increases in individual market premiums, although the precise magnitude of those increases is uncertain." (The Brookings Institution)
Are Medicare Part D Disclosure Notices Required for an HRA or Health FSA?
"The answer is probably yes for the HRA, and no for the health FSA. This assumes that your company's health FSA and HRA will offer prescription drug coverage to Part D-eligible individuals -- i.e., individuals covered under Medicare Part A or Part B, including active and disabled employees, COBRA participants, retirees, and their covered spouses and dependents who live in the service area of a Part D prescription drug plan." (Thomson Reuters / EBIA)
[Opinion] Partnership for Employer-Sponsored Coverage Comment Letter to Agencies on Proposed Rules to Expand HRAs (PDF)
"The Partnership remains concerned about the level of complexity, costs and burdens that may be associated with the verification and notification processes referenced in the proposed rule regarding the offer of an HRA for [individual healthcare coverage] purchase. The current ACA 6055 and 6056 reporting burdens loom large over employers and any additional burdens resulting from a new verification and notification process under the proposed rule may deter employers from offering coverage all together." (Partnership for Employer-Sponsored Coverage [P4ESC])
[Guidance Overview] HRA Expansion: An In-Depth Look at the Proposed Rule
"Without any new guidance or modification, employers that offer different HRA maximums to different classes or raise their HRA contribution due to change in age, under the age-banded premium categories in the individual market, would violate the 105(h) rules. Treasury and IRS anticipate releasing future guidance to address these situations." (Compliance Cornered Blog)
[Guidance Overview] Guidance on Integrating Proposed HRA Rule with Employer Mandate
"[IRS Notice 2018-88] addresses the interaction between the proposed HRA rule and the ACA employer mandate provisions and nondiscrimination rules under the tax code, and proposes changes so these provisions would work with [individual coverage HRAs]. The effective date ... matches the effective date in the proposed HRA rule, which is plan years beginning on or after January 1, 2020. Like the proposed HRA rule, the proposed guidance may not be relied upon by taxpayers and others[.]" (Willis Towers Watson)
[Guidance Overview] Agencies Propose HRA Expansion
"Large employers, as well as employers of any size that deploy group health coverage for recruiting and retention purposes will not likely have much interest. But because individual coverage HRAs are themselves group health plans that provide MEC, they might find purchase in industries with large cohorts of contingent and variable workers -- e.g., restaurants, retail, staffing, and hospitality -- that currently offer so-called preventive-services-only plans." (Mintz)
[Opinion] Evaluating the Administration's Health Reimbursement Arrangement Proposal
"[T]his new option would likely be particularly appealing to large employers with sicker workforces.... [S]ubsidizing community-rated individual market coverage could allow them to offer similar coverage at lower cost.... [T]he influx of sicker workers into the individual market would increase premiums, thereby increasing subsidy costs for the federal government and premiums for unsubsidized enrollees." (The Brookings Institution)
[Guidance Overview] Departments Propose Expanding Employers' HRA Options
"To facilitate access to individual coverage HRAs, employees and their dependents would have new marketplace special enrollment opportunities ... where an employer begins offering an individual coverage HRA mid-year, as well as where an employee becomes eligible for an individual coverage HRA mid-year. An individual would have 60 days before and after becoming enrolled in an individual coverage HRA or QSEHRA in which to enroll in marketplace coverage." (Buck)
Proposed Rules Would Expand Access to HRAs (PDF)
"[T]he plan sponsor could offer a group health plan to one group of participants and an Individual Coverage HRA to other groups.... Individual Coverage HRAs would have to be offered to all participants within a designated class on the same terms. However, the amount a plan sponsor contributes to an Individual Coverage HRA could vary based on age, family size or both." (Segal Consulting)
[Guidance Overview] IRS Begins Discussing HRAs, the ACA Employer Mandate, and Nondiscrimination
"The new proposed rules allowing employers to reimburse for individual insurance policies ... included some options that could, or would, violate existing nondiscrimination rules that apply to [HRAs] and other self-insured health plans. The IRS is now starting to address those concerns with the release of Notice 2018‑88.... [T]he Notice is just an expression of where the IRS expects to go. While it is a helpful breadcrumb in that process, employers cannot start implementing this now." (HUB International)
[Guidance Overview] New IRS and Treasury Guidance on Safe Harbors for HRAs
"As proposed, the new rule would allow HRAs to be used to fund premiums and out-of-pocket costs for individual health insurance coverage for plans beginning on or after January 1, 2020. Notice 2018‑88 is complex but designed to make it easier for employers to offer an individual HRA under the proposed HRA rule ... Notice 2018‑88 -- and the positions taken by the IRS and Treasury Department in the guidance -- could have significant consequences for whether employers opt to move forward with offering individual HRAs to employees." (Katie Keith, in Health Affairs)
[Opinion] The Tortuous History of HRAs: What Does the Future Hold?
"Which employers would go in this direction, under what circumstances, and for which employees? Would it vary by firm size? Do the strength of the economy and labor market conditions factor in? ... Employers may decide that they no longer need to offer health benefits to be competitive in the labor market during the next recession, and the combination of the insurance market reforms and the ability to give workers tax-free money to purchase health insurance on their own may finally put the future of employment-based health coverage to the test." (Paul Fronstin, EBRI [Employee Benefits Research Institute])
[Guidance Overview] IRS Requests Comments on Application of Employer Shared Responsibility and Nondiscrimination Requirements to Individual Coverage HRAs
"The [IRS] recently released proposed regulations regarding the ability to integrate health reimbursement arrangements and other account-based group health plans (HRAs) with individual health insurance coverage. IRS Notice 2018‑88 sets forth anticipated guidance and requests comments on the application of the employer shared responsibility requirements in Internal Revenue Code Section 4980H and the nondiscrimination requirements of Code Section 105(h) to such HRAs. The Notice states that it cannot be relied upon by taxpayers with regard to Code Sections 4980H or 105(h), but gives an indication as to the IRS guidance that can be expected on these topics." (Winston & Strawn LLP)
Employer Options for Health Insurance May Expand with New HRA Rules
"The departments estimate that 1 million employees will enroll in individual coverage with access to an [individual coverage HRA (ICHRA)] in 2020, with that number growing to 10.3 million by 2024. About two thirds of that group are estimated to come from traditional employer-sponsored group health coverage. The departments predict 800,000 companies will offer ICHRAs in 2024, while suggesting the vast majority of adopters will be small to midsize employers." (Willis Towers Watson)
New Proposed Regs Would Expand HRAs (PDF)
"These proposed rules will allow employers to offer HRAs that integrate with individual health insurance coverage. Any employer (not just small employers) can offer an HRA that integrates with an employee's or family member's individual insurance coverage. The insurance coverage could be purchased on or off the Marketplace. To receive a reimbursement from the HRA for health expenses or premiums, employees must verify they and any eligible family members have individual coverage." (Marsh & McLennan Agency LLC)
[Guidance Overview] Proposed Rule Expands HRA Usage and Forecasts Safe Harbors for ACA Employer Mandate Compliance
"By moving to a 'defined contribution' model, employers would be able to cap their annual health care spending and shift the risk to insurance companies. However, unless employers provide substantial HRA contributions, employees would bear the brunt of cost increases imposed by insurers in the individual market. Further, without the combined risk pool that comes with a group health plan, employees may find it difficult to replicate their current coverage without increasing their out-of-pocket expenditures." (Littler)
[Official Guidance] Text of IRS Notice 2018-88: Section 4980H -- Shared Responsibility for Employers Regarding Health Coverage, and Section 105 -- Amounts Received Under Accident and Health Plans (PDF)
31 pages. "[Recent] proposed regulations would expand the usability of HRAs by eliminating the current prohibition on integrating HRAs with individual health insurance coverage, thereby permitting employers to offer HRAs to employees enrolled in individual health insurance coverage.... The proposed integration regulations and the proposed [premium tax credit (PTC)] regulations raise issues under the Code, in particular concerning the application of section 4980H (the employer shared responsibility provisions) and section 105(h) (addressing discriminatory self-insured group health plans). This notice is intended to initiate and inform the process of developing guidance that addresses these issues, and requests comments on potential approaches developed by the Treasury Department and the IRS....

"In order to provide clarity to stakeholders, section III.A of this notice explains how section 4980H(a) would apply to an ALE that offers an individual coverage HRA. In addition, section III.B of this notice explains how section 4980H(b) (including the current affordability safe harbors) would apply to an ALE that offers an individual coverage HRA, describes potential additional affordability safe harbors, requests comments, and provides examples." (Internal Revenue Service [IRS])

IRS Updates Health and Fringe Benefit Plan Limits
"The IRS has updated various health and fringe benefit plan limits for 2019. A comparison of the 2019 and 2018 limits is listed [in a chart]." (Kilpatrick Townsend)
IRS Announces Benefit Plan Limits for 2019 (PDF)
2-page printable chart shows limits for 2018 and 2019, as well as important deadlines for 2019. (Lockton)
[Guidance Overview] Proposed Regs for Health Reimbursement Arrangements
"The Departments issued proposed regulations that allow for stand-alone, excepted benefit HRAs [EBHRAs].... The EBHRA is not subject to the Market Reform Rules, and coverage under the EBHRA does not make an individual ineligible for the PTC. There are four requirements for the EBHRA.... Prior to the passage of the ACA, many employers offered HRAs to employees. Due to the limitations in the ACA, these plans became scarce ... Employers will likely welcome having the opportunity to offer employees an EBHRA." (Trucker Huss)
[Guidance Overview] Proposed Regs Would Permit Employers to Reimburse Employee Premiums for Health Insurance Purchased in the Individual Market
"If these regulations ... are finalized in their current form, employers may choose to eliminate their group health plan coverage and establish an HRA that reimburses the cost of individual health coverage purchased by employees, if certain conditions are met. The proposed regulations even suggest that the regulators may create special rules that would treat an employer sponsoring one of these HRAs as fully satisfying the [ACA's] employer mandate ... This could potentially lead to a shift from traditional group health plans to a 401(k)-like defined contribution approach towards employer-provided health coverage, likely to be most popular with smaller employers." (Foley & Lardner LLP)
Don't Forget to Set Your HRA COBRA Premiums!
"[U]sing a look back to the previous 12-month plan year period and calculating a cost per participant to determine the actual cost is the most common method ... Be prepared to then determine single versus family COBRA HRA rates and how to properly apply those to qualified beneficiaries." (Frenkel Benefits)
[Guidance Overview] Expanded Usability of HRAs Under the Proposed Rule
"Integrated HRAs may be particularly attractive to small employers who are not required to offer coverage under the employer mandate but who wish to provide workers with health care coverage as a means of attracting talent and retaining employees.... Under the Proposed Rule, an employer would not be permitted to offer both an Integrated HRA and an Excepted Benefit HRA to the same employee, but an employer could offer one of these HRA arrangements to one class of employees and the other HRA arrangement to a different class of employees." (Drinker Biddle)
[Guidance Overview] Key Changes under the Proposed Rule for Health Reimbursement Arrangements
"[1] Remove the current prohibition on integrating an HRA with individual health insurance coverage. [2] Expand the definition of 'limited excepted benefits' to include HRAs that meet certain requirements.... [3] Clarify that integration of an HRA or a QSEHRA with individual health insurance coverage does not cause the individual health insurance coverage to become subject to ... [ERISA] if certain requirements are met. [4] Create a special enrollment period in the individual health insurance market that enables individuals to enroll when they become eligible for HRA or QSEHRA coverage that can be integrated with individual health insurance coverage." (Ogletree Deakins)
[Guidance Overview] Agencies Respond to Trump Order, Issue Proposed Regs Paving Way for More HRAs
"The proposed 'Integrated HRA' rules would permit employers of any size to offer a standalone HRA to employees and former employees who have individual health coverage.... As an alternative to the Integrated HRA option, the Proposed Rule would recognize certain HRAs as limited excepted benefits (Excepted Benefit HRA). An Excepted Benefit HRA would allow participants to obtain reimbursement for certain qualified expenses even if they choose not to enroll in an employer's group health plan coverage." (McDermott Will & Emery)
[Guidance Overview] IRS Proposed Regs Would Reinvigorate HRAs, But Add Complexity
"[Future IRS] guidance is expected to create a safe harbor allowing the employer to satisfy the minimum value requirement if the employee's individual health insurance policy meets 'minimum value' (at least 60 percent actuarial value) and if, taking into account the employer's subsidy through the HRA, the premium cost to the employee is affordable.... [An] employer would be allowed to offer group major medical coverage to full-time employees but only an HRA to part-time employees, or offer group major medical coverage to employees in one state but only an HRA to employees in another state." (Lockton)
[Guidance Overview] Proposed Rules Would Permit HRAs to Be Integrated with Individual Health Insurance Coverage
"The proposed regulations would permit HRAs to be integrated with individual health insurance coverage if the following six conditions are met. [1] All individuals covered by an HRA must be enrolled in individual coverage... [2] Restriction involving the same class of employees... [3] Same-terms requirement... [4] Opt-out provision... [5] Substantiating individual health insurance coverage... [6] Notice requirement." (Thomson Reuters Practical Law)
[Guidance Overview] New Day for HRAs: The Ins and Outs of the New Proposed Regulation (PDF)
13 pages, Nov. 1, 2018. "This proposed regulation, which will be effective for plan years beginning on or after January 1, 2020 (and cannot be relied on before the effective date), makes drastic changes to the rules currently applicable to HRAs offered to active employees." (Alston & Bird)
[Guidance Overview] An Employer's Guide to Proposed Regulations Expanding HRAs
"[S]tarting in 2020: [1] employers of any size not offering health coverage to all or certain employee classes could use HRAs to reimburse those employees for the cost of individual health insurance coverage (IHIC), subject to certain conditions; and [2] employers offering traditional group coverage could provide an HRA up to $1,800 annually (indexed) to reimburse employees for certain qualified medical expenses." (Davis Wright Tremaine LLP)
[Guidance Overview] Proposed Rules Allow the Use of HRAs to Pay For Individual Market Coverage
"[T]he Departments have proposed a fairly significant substantiation of coverage requirement on employers sponsoring the [Individual Coverage HRAs (ICHRA)].... [T]he Proposed Regulations do not permit employers to distinguish between salaried and hourly employees.... [T]he Proposed Regulations would require that former employees be treated as being in the same class to which they belonged immediately prior to their separation from service.... [T]he current rules that permit retiree-only HRAs are still in effect[.]" (Groom Law Group)
[Guidance Overview] Proposed U-Turn on Employers Paying for Individual Policies Leaves Questions Unanswered
"[E]mployers should bear in mind that the existing rules (which impose substantial penalties for reimbursing for individual health insurance premiums) still apply.... The rules allow employers to offer the HRA only to specific classes of employees (or a combination of classes) ... Notably absent from the list is salaried versus hourly.... [T]he Departments did remove a key hurdle. The proposed new rules would not make the individual insurance policies part of the ERISA plan." (HUB International)
[Guidance Overview] Trump Administration Moves to Incentivize Health Reimbursement Arrangements
"This post offers background information on HRAs; summarizes the proposed rule; and discusses the rule's potential implications for employers, employees, and the individual insurance market. Comments on the proposal are due within 60 days." (Katie Keith, in Health Affairs)
Choosing the Right Flexible Benefit for Employees
"Trying to decide which of the many employer-sponsored benefits out there to offer employees can leave an employer feeling lost in a confusing bowl of alphabet soup -- HSA? FSA? DCAP? HRA? ... While there are many details to cover for each of these benefit options, perhaps the first and most important question to answer is: which of these benefits is going to best suit the needs of both my business and my employees?" (United Benefit Advisors)
[Guidance Overview] A New Direction for Health Reimbursement Arrangements
"Under the proposed rules, differences in the amount of HRA contributions can be based on an employee's work location. However, availability of individual Exchange coverage is based on an individual's place of residence. Employees at the same work location could live in multiple rating areas. Therefore, the employer's HRA contribution would buy varying amounts of coverage for its employees, even if the employer makes adjustments for age and family size, because of differences in individual insurance coverage options and costs." (Winston & Strawn LLP)
[Guidance Overview] New Guidance Creates a New Playing Field for HRAs
"The new rules provide that HRAs may be integrated with individual health coverage -- whether purchased through a Health Insurance Exchange or otherwise -- by meeting specified requirements ... Small employers, in particular, may make widespread use of HRAs once the new rules take effect. Many of the rules are aimed at creating an environment that will further stabilization of the individual insurance market by bringing in a broad segment of employed individuals." (Ballard Spahr LLP)
[Guidance Overview] 2018 End of Year Health and Welfare Plan Sponsor 'To Do' List
"Comply with large employer shared responsibility rules if applicable, or pay penalties ... Consider amendments to align plan with Code Section 4980H full-time employee determinations ... Association Health Plans ... Health Reimbursement Arrangements ... FMLA tax credit ... Consider impact of new disability claims regulations ... Consider impact of nondiscrimination rules ... Reconsider offering domestic partner benefits ... Review grandfathered status ... Be ready for HIPAA Phase 2 audits ... Review wellness programs ... Consider proper treatment of telemedicine benefits ... Distribute revised Summaries of Benefits and Coverage ... Distribute Summary Annual Report ... Gear up for the Cadillac Tax ... Consider offering alternatives to opioids and easy access to addiction support services ... Reflect cost-of-living increases." (Snell & Wilmer)
Employers Combat Healthcare Costs Through HSAs, Wellbeing and Pharmacy Benefit Measures
"Though companies expect a slight upswing in healthcare cost increases over the next two years or so, cost trends remain at or below 5 percent after plan changes ... This is due, in part, to the maturing of account-based health plans, a strategy that combines a group health insurance plan with an employee flexible spending account or health savings account.... [E]mployer confidence in offering health benefits in 10 years remains strong, and in fact that confidence is close to its highest level in 15 years." (Healthcare Finance News)
[Guidance Overview] Employer-Provided HRAs for Individuals to Purchase Health Insurance -- A Remedy for High Health Benefit Costs?
"The proposal will not to apply to group health plans or health insurance issuers until January 1, 2020. This proposal will require new processes, notices, plan documents and careful consideration by employers to implement it effectively.... The purpose of this alert is to provide some quick answers for common questions this proposal may raise as leaders think about long term options." (Winstead PC)
[Guidance Overview] Departments Propose Regs Permitting HRAs for Individual Policies
"Employees covered by [an] HRA must be enrolled in an individual policy. Employees who cease to be covered by the individual policy must forfeit the HRA.... [E]mployers may permit employees to use the section 125 cafeteria plan to contribute on a pre-tax basis for non-exchange individual market coverage.... Employees must have the option to opt-out of the HRA coverage to maintain eligibility for subsidies on the exchange ... The HRA must have reasonable procedures in place to verify that anyone covered by the HRA is actually enrolled in individual health insurance coverage.... The proposed regulations also provide a new mechanism for employers to offer an HRA of up to $1,800 in value that is not integrated with individual market (or any other) coverage.... The proposed regulations would continue to treat an HRA as an 'eligible employer-sponsored plan' to qualify as minimum essential coverage[.]" (ABD Insurance & Financial Services)
[Guidance Overview] Federal Government Releases Proposed Regs That Will Expand the Use of HRAs
"The proposed rules would ... allow two new types of HRAs: [1] An individual health insurance premium reimbursement HRA ... [2] An excepted benefit HRA that generally allows up to $1800 per year (plus carryover amounts) in reimbursement for medical expenses (OTHER than health insurance premiums) provided that employees are offered coverage under another group health plan sponsored by the employer." (Employers Council on Flexible Compensation [ECFC])
[Guidance Overview] Agencies Announce Proposal to Expand Access to Quality, Affordable Health Coverage
"Because medical expense reimbursements from HRAs are tax-preferred, HRAs -- that workers and their families use to purchase coverage of their choosing -- provide the same tax advantage enjoyed by traditional employer-sponsored coverage. The proposed regulation would not alter the tax treatment of traditional employer-sponsored coverage. It would merely create a new tax-preferred option for employers of any size to use when funding employee health coverage. While the employer would fund the cost of individual health insurance coverage, the employee would own the coverage, allowing the employee to keep the coverage even if he or she left the employer and was no longer covered by the HRA. In the near term, the proposed regulation, if finalized, would provide opportunities to employers, especially small and mid-size employers who have struggled to offer coverage, to fund the cost of individual health insurance coverage on a tax-preferred basis." (Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL])
Trump Administration Expands Health Reimbursement Arrangements for Marketplace Coverage
"Under the new rule, HRA money would remain exempt from federal and payroll income taxes for employers and employees. Additionally, employers with traditional coverage would be permitted to reserve $1,800 for supplemental benefits like vision, dental and short-term health plans." (FierceHealthcare)
Trump Administration Loosens Restrictions on Health Reimbursement Arrangements
"While the new proposed rule does not eliminate the employer mandate penalty, it would allow HRAs used to pay for individual insurance premiums on the exchange or off the exchanges to satisfy the employer mandate, depending on whether the HRA is affordable. That would depend in part on the amount the employer contributes to the HRA." (Modern Healthcare Online; free registration required)
When Can an Employer Reimburse Individual Health Insurance Premiums? (PDF)
"[1] Qualified Small Employer Health Reimbursement Arrangement (QSEHRA).... [2] Spousal health reimbursement arrangement.... [3] Medicare reimbursement arrangement.... [4] Retiree reimbursement arrangement.... [5] Opt-out/waiver payment." (OneDigital Health and Benefits)
HSAs Can Reduce Your Employees' Fear of High Deductibles
"[T]he easiest way to put your employees' minds at ease is for you to contribute to their HSA to provide a cushion.... Another option would be to offer a match of employee contributions.... [Consider] attaching a Post-Deductible Health Reimbursement Arrangement (HRA)." (OneDigital Health and Benefits)
Companies Offering CDHPs, HSAs, FSAs, and HRAs in 2018
"CDHPs rose from 30% in 2014 -- and 23% in 2017 -- to 40% in 2018 ... While CDHPs have grown overall, somewhat surprisingly the prevalence of full replacement CDHPs actually decreased very slightly, down to 3% in 2018 from 4% in 2017.... [T]he number of employers offering health reimbursement arrangements (HRAs) has remained relatively steady in the last five years, growing in prevalence by 2% from 2014 to 2018." (Connect Your Care)
House Adopts Bills Enhancing HSAs, FSAs, and HRAs
"Individuals would now be able to purchase over-the-counter (OTC) medications with an HSA, FSA, or HRA without being required to obtain a prescription for eligibility purposes ... Certain sports and fitness expenses -- including gym memberships and the cost to participate in certain physical exercise programs -- would be treated as qualified medical expenses up to a limit of $500 a year for an individual and $1,000 a year for a joint return ... HSA contribution would be raised to $6,650 for individuals and $13,300 for families ... Individuals would no longer be barred from contributing to an HSA if his/her spouse is enrolled in a medical FSA ... Spouses over the age of 55 would be able to make 'catch-up' contributions to the same HSA." (Connect Your Care)
What is QSEHRA? A Practical Guide for Small Employers
"To use a QSEHRA, a small business or non-profit must meet two primary requirements: [1] Be 'small' ... [2] Not have a group health plan ... To receive tax-free reimbursements from a QSEHRA, an employee must: [1] Be covered by an insurance plan ... [2] Submit a claim for reimbursement." (Take Command Health)
Must Employers Report QSEHRA Benefits on Form W-2?
"If an employee was covered under a qualified small employer health reimbursement arrangement (QSEHRA), the employer must report the total amount of the employee's permitted QSEHRA benefit on Form W-2 in Box 12, using Code 'FF' ... IRS guidance clarifies that an employer must report the amount of payments and reimbursements that the eligible employee is entitled to receive from the QSEHRA for the calendar year (the employee's 'permitted benefit'), without regard to the payments or reimbursements actually received." (Thomson Reuters / EBIA)
Rethinking Your Organization's Health Care Plan? Consider These Factors in Consumer Health Care
"If you are offering CDHPs to your employees, you need to consider offering tax-advantaged benefits. They provide a means of financing out-of-pocket health care costs and help many Americans afford critical health care expenses. For nonprofit organizations, it's often difficult to compete with for-profits when it comes to employee benefits -- affordable health care, in particular. These tax-advantaged accounts help your organization manage the cost of health care as an employer while helping employees do the same." (Martin Trussell, in Forbes)
Small Employers Cut Health Care Costs Using Stand-Alone HRAs
"More than 70 percent of small businesses using a new type of health reimbursement arrangement (HRA) last year did so to offer employee health benefits for the first time ... These early adopters also spent less on health benefits than small employers that provide employees with group health coverage." (Society for Human Resource Management [SHRM])
Small Group Savior? Another Look at QSEHRAs
"Employers still have to comply with a variety of notice and reporting requirements that carry high excise taxes for non-compliance. Reimbursements have to be substantiated and verified before payment is made or the QSEHRA risks losing the tax-advantage status for all participants -- even if due to administrative error." (Frenkel Benefits)
Can a Company's Owners Participate in Its HRA?
"The answer depends on several factors, including how your company is organized and the amount of the company owned by each working owner.... Ineligible owners include partners, sole proprietors, and more-than-2% shareholders in a Subchapter S corporation. Stock ownership by employees of a Subchapter C corporation does not preclude their tax-favored HRA participation." (Thomson Reuters / EBIA)
[Guidance Overview] Summary of Qualified Small Employer Health Reimbursement Arrangements (QSEHRAS)
"The QSEHRA provides a permitted benefit to eligible employees -- the maximum amount of the payment or reimbursement available to each employee. The permitted benefit cannot exceed statutory dollar limits that are indexed for inflation for years after 2016.... Unused permitted benefits from one year can be carried-over to the next year ... [If] the carryover amount from a prior year plus the current year's permitted benefit exceeds the current year's statutory limit, some portion of the carryover is forfeited." (Ice Miller LLP)
2018 Healthcare Trends
"The constant demand for the latest and greatest in technology could have the greatest impact on healthcare in 2018. Innovations in digital technology are spurring a rise in data management and improving the delivery of medical care." (DataPath)
[Guidance Overview] IRS Provides Guidance on Qualified Small Employer Health Reimbursement Arrangements
"According to [IRS Notice 2017-67], a separate benefit up to the maximum permitted benefit must be provided to each eligible employee, regardless of whether employees are covered under an individual health policy or a family policy. Therefore, spouses who work for the same employer and who are covered under a family policy must both receive the full family benefit coverage.... However, eligible employees may not be reimbursed for duplicate costs, so the total premium reimbursement for Employees A and B may not exceed the $10,000 annual premium for their family health insurance policy." (von Briesen & Roper, s.c.)
 
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