Tom Posted May 18, 2018 Posted May 18, 2018 We have a small business w 10 employees and the business offers health insurance. So the QSEHRA is not available. Two employees have chosen Medicare instead of the employer health plan. The employer pays 75% of the health insurance premium and employee 25%. The employer wishes to reimburse the Medicare-covered employees 75% of the Medicare premium they incur. There appears to have been a pronouncement in 2015 which allows for this provided certain conditions have been met which they have in this case. So it appears to be allowable. Questions: Is this still an allowable benefit? Does there need to be a written plan? If so I suppose it would be an HRA. Can the HRA only address and cover the Medicare reimbursement issue? I assume the reimbursement would be non-taxable. Comments? Thanks
Luke Bailey Posted May 18, 2018 Posted May 18, 2018 See Q&A-3 of Notice 2015-7. It seems that as long as the Medicare folks were offered the employer's health insurance plan and declined it, and the Medicare reimbursement is limited to Parts B and D, and Medigap, as described in Q&A-3, you should not have a penalized "employer payment plan" under what you describe. Otherwise you would. The Q&A also points out there may be issues under Medicare Secondary Payer. However, if you have fewer than 20 employees (check the way CMS counts this), you should be OK. Anyway, I think all that MSP would knock out would be the Medigap premiums, not the Parts B and D premiums. Luke Bailey Senior Counsel Clark Hill PLC 214-651-4572 (O) | LBailey@clarkhill.com 2600 Dallas Parkway Suite 600 Frisco, TX 75034
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